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Influence of estrogen levels on thermal perception, pain thresholds and pain tolerance: Studies on women undergoing in vitro fertilization
Linköping University, Department of Clinical and Experimental Medicine, Cell Biology. Linköping University, Faculty of Health 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.
Linköping University, Department of Clinical and Experimental Medicine, Cell Biology. Linköping University, Faculty of Health Sciences.
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2012 (English)In: Journal of Pain, ISSN 1526-5900, E-ISSN 1528-8447, Vol. 13, no 5, 459-466 p.Article in journal (Refereed) Published
Abstract [en]

We examined the relationship between estrogen and pain in women undergoing in vitro fertilization (IVF). Quantitative sensory tests (QST) were performed twice during the IVF-regimen: once during hormonal down-regulation and once during hormonal upregulation. A group of healthy men and a group of women using monophasic contraceptives were also examined, to control for session-to-session effects. Among the women undergoing IVF, serum 17β-estradiol levels differed strongly between treatments as expected, and increased from 65.7 (SD = 26) pmol/l during the downregulation phase, to 5188 (SD = 2524) pmol/l during the up-regulation phase. Significant outcomes in the QST were only seen for temperature perception thresholds (1.7°C vs. 2.2°C; P = 0.003) and cold pain threshold (11.5°C vs. 14.5°C; P = 0.04). A similar change in cold pain threshold was also seen in the two control groups, however, and statistical analysis suggested that this change was due to a session-to-session effect rather than being the result of hormonal modulation. Heat pain thresholds, heat tolerance, pressure pain thresholds, and the cold pressor test showed no significant differences between sessions. These data demonstrate that pain perception and pain thresholds in healthy women show little, if any, changes even with major variations in serum estradiol levels.

Place, publisher, year, edition, pages
2012. Vol. 13, no 5, 459-466 p.
Keyword [en]
Estrogen, pain, hormonal levels, quantitative sensory testing
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-71869DOI: 10.1016/j.jpain.2012.01.446ISI: 000304228700005OAI: oai:DiVA.org:liu-71869DiVA: diva2:454826
Note

funding agencies|Swedish Research Council| 7879 |Konung Gustav V:s 80-arsfond||Health Research Council in the South-East of Sweden||Linneus University, Kalmar, Sweden||

Available from: 2011-11-08 Created: 2011-11-08 Last updated: 2017-12-08Bibliographically 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)
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Supervisors
Available from: 2011-11-08 Created: 2011-10-06 Last updated: 2011-11-08Bibliographically approved

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Stening, KentBerg, GöranHammar, MatsEriksson, OlleAmandusson, ÅsaBlomqvist, Anders

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