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Hormonal replacement therapy does not affect self-estimated pain or experimental pain responses in post-menopausal women suffering from fibromyalgia: a double-blind, randomized, placebo-controlled trial
Linköping University, Department of Clinical and Experimental Medicine, Cell Biology. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Computer and Information Science, Statistics. Linköping University, Faculty of Arts and Sciences.
Linköping University, Department of Clinical and Experimental Medicine, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medicine, Pain and Rehabilitation Centre.
Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
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2011 (English)In: RHEUMATOLOGY, ISSN 1462-0324, Vol. 50, no 3, 544-551 p.Article in journal (Refereed) Published
Abstract [en]

Methods. Twenty-nine post-menopausal women were randomized to either 8 weeks of treatment with transdermal 17 beta-oestradiol (50 mu g/day) or placebo according to a double-blind protocol. A self-estimation of pain, a set of quantitative sensory tests measuring thresholds to temperature, thermal pain, cold pain and pressure pain, and a cold pressor test were performed on three occasions: before treatment, after 8 weeks of treatment and 20 weeks after cessation of treatment. Results. Hormonal replacement treatment significantly increased serum oestradiol levels as expected (P andlt; 0.01). However, no differences in self-estimated pain were seen between treatment and placebo groups, nor were there any differences between the two groups regarding the results of the quantitative sensory tests or the cold pressor test at any of the examined time points. Conclusion. Eight weeks of transdermal oestradiol treatment does not influence perceived pain, pain thresholds or pain tolerance as compared with placebo treatment in post-menopausal women suffering from FM.

Place, publisher, year, edition, pages
Oxford University Press , 2011. Vol. 50, no 3, 544-551 p.
Keyword [en]
Oestrogen, Substitution, Pain, Hormonal levels, Quantitative sensory testing, Cold pressor test
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-66851DOI: 10.1093/rheumatology/keq348ISI: 000287745600016OAI: oai:DiVA.org:liu-66851DiVA: diva2:405497
Available from: 2011-03-22 Created: 2011-03-21 Last updated: 2011-11-08
In thesis
1. The effect of gonadal hormones on the sensation of pain: Quantitative sensory testing in women
Open this publication in new window or tab >>The effect of gonadal hormones on the sensation of pain: Quantitative sensory testing in women
2011 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Accumulating evidence points to sex differences in pain sensitivity and many chronic pain conditions preferentially affect women. Sex hormones, and in particular estrogens, have been shown to affect pain processing and pain sensitivity in animals, although the findings are divergent. The aim of the research on which this thesis is based was to examine the effect of gonadal hormones on the sensation of pain in women who either presented normal variations in hormonal levels over time or who had been given hormone treatment.

Different quantitative sensory tests (QST) examining temperature thresholds, cold, heat and pressure pain thresholds, as well as tolerance thresholds for heat and cold, were performed during different hormonal conditions: During hormonal fluctuations throughout the ovulatory cycle (papers I, II); in women undergoing in vitro fertilization (IVF), a treatment associated with extremely low and high 17β-estradiol levels (paper III); and before and after hormonal substitution treatment in postmenopausal women suffering from fibromyalgia (paper IV).

The results showed little changes in pain sensitivity during the ovulatory cycle, with an interaction between 17β-estradiol and progesterone on cold pressor pain as the major finding. No significant changes in pain sensitivity were seen even with the extreme variations in 17β-estradiol levels that occurred during the IVF-treatment. Also, the use of hormonal substitution treatment did not affect pain thresholds or tolerance in postmenopausal women suffering from fibromyalgia.

Session-to-session effects were reported in several studies and seem to be an important factor when using repeated sessions design. Additionally, the present work also emphasizes the use of actual hormonal values as essential instead of tentative calendar methods when evaluating hormonal effects on the sensation of pain during the menstrual cycle. 

The present studies thus indicate that changes in gonadal hormone levels have little effect on experimental pain in women, contrary to what has been reported in animal studies.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2011. 84 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1258
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-71210 (URN)978-91-7393-079-6 (ISBN)
Public defence
2011-11-30, Berzeliussalen, Hälsouniversitetet, Campus US, Linköpings universitet, Linköping, 13:00 (Swedish)
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Available from: 2011-11-08 Created: 2011-10-06 Last updated: 2011-11-08Bibliographically approved

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Stening, KentEriksson, OlleHenriksson, Karl-GöstaBrynhildsen, JanLindh-Åstrand, LottaBerg, GöranHammar, MatsBlomqvist, Anders

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Stening, KentEriksson, OlleHenriksson, Karl-GöstaBrynhildsen, JanLindh-Åstrand, LottaBerg, GöranHammar, MatsBlomqvist, Anders
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Cell BiologyFaculty of Health SciencesStatisticsFaculty of Arts and SciencesRehabilitation MedicinePain and Rehabilitation CentreObstetrics and gynecologyDepartment of Gynecology and Obstetrics in Linköping
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