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Pain thresholds and pain tolerance during the ovulatory cycle in healthy women: quantitative sensory testing
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, 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.
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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(English)Manuscript (preprint) (Other academic)
Abstract [en]

Hormonal influence on pain sensitivity at different menstrual phases is a field of contradictory results. One reason is methodological differences between studies and methodological limitations such as lack of confirmation of cycle phase by measurement of actual hormone levels. In the present study, 14 healthy women were followed during three menstrual cycles and were subjected to a battery of quantitative sensory tests 1-4 after start of menses (follicular phase) and 2-11 days before next menses (luteal phase). The material was analyzed in three different ways: cycle phase determined according to the calendar method; cycle phase determined by hormone values, with cycles showing hormone values outside reference values omitted; and cycles subdivided into three subgroups depending on hormone profile (“normal” cycle; high s-estrogen during the assumed luteal phase; and low progesterone during the assumed luteal phase). However, neither analysis showed any significant differences between the measurement done during immediate after onset of menses and those performed in the period before next menses. Consistent with the results of several previous studies, the findings indicate that pain sensitivity does not seem to vary as a function of the menstrual cycle.

Keyword [en]
Estrogen, pain, hormonal levels, quantitative sensory testing
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-71868OAI: oai:DiVA.org:liu-71868DiVA: diva2:454818
Available from: 2011-11-08 Created: 2011-11-08 Last updated: 2011-11-08Bibliographically approved
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)
Opponent
Supervisors
Available from: 2011-11-08 Created: 2011-10-06 Last updated: 2011-11-08Bibliographically approved

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Stening, KentEriksson, OlleHammar, MatsBerg, GöranBlomqvist, Anders

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Cell BiologyFaculty of Health SciencesStatisticsFaculty of Arts and SciencesObstetrics and gynecologyDepartment of Gynecology and Obstetrics in Linköping
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