Comparing Pain Sensitivity and the Nociceptive Flexion Reflex Threshold Across the Mid-follicular and Late-luteal Menstrual Phases in Healthy Women
Comparing Pain Sensitivity and the Nociceptive Flexion Reflex Threshold Across the Mid-follicular and Late-luteal Menstrual Phases in Healthy Women
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DOI：
10.1097/ajp.0b013e31824c5edb
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发表时间：
2013-02-01
影响因子：
2.9
通讯作者：
Rhudy, Jamie L.
中科院分区：
文献类型：
--
作者：
Bartley, Emily J.;Rhudy, Jamie L.
目的：了解月经周期和疼痛之间的关系可以大大有助于我们对女性疼痛处理的了解。许多早期研究表明，相对于卵泡期，月经周期的黄体期疼痛敏感性增强;然而，这些研究往往受到样本量小、缺乏排卵验证、专注于单一疼痛模式、对月经周期规律性评估不足以及统计方法效力低下等因素的限制。目前的研究旨在解决这些局限性，并检查在疼痛处理的差异之间的中期卵泡（第5至8天）和黄体晚期（月经前1至6天）阶段。41名健康、定期骑自行车的女性参加了测试，这些测试从机械疼痛阈值、电皮肤疼痛阈值/耐受性和缺血疼痛阈值/耐受性测量疼痛敏感性，以及麦吉尔疼痛问卷对电刺激和缺血刺激的感觉和情感评分。皮肤电刺激也被用来评估伤害性屈曲反射阈值，脊髓nociception.Results的生理措施：当分析仅限于在目标月经期（N = 30）收集的数据，结果表明没有月经期对任何疼痛结果的影响（所有P的> 0.05），除了较低的皮肤电疼痛阈值在黄体晚期。在完整样本中，不同月经期的结局无差异（N = 41）。这表明伤害性反应之间的中期卵泡和晚期黄体phase.Discussion：本研究表明，实验性疼痛处理之间没有显着不同的中期卵泡和晚期黄体阶段的月经周期在健康女性。这意味着这两个阶段的激素变化（即孕酮）对疼痛的主观和生理反应的影响最小。
Objectives: Understanding the relationship between the menstrual cycle and pain can contribute significantly to our knowledge of pain processing in women. Many early studies suggested that pain sensitivity was enhanced during the luteal phase of the menstrual cycle relative to the follicular phase; however, these studies were often limited by small sample sizes, lack of ovulation verification, focus on a single pain modality, inadequate assessment of menstrual cycle regularity, and low-powered statistical methods. The current study was designed to address these limitations and examine the difference in pain processing between the mid-follicular (days 5 to 8) and late-luteal (days 1 to 6 preceding menses) phases.Methods: Forty-one healthy, regularly cycling women attended testing sessions that measured pain sensitivity from mechanical pain threshold, electrocutaneous pain threshold/tolerance, and ischemia pain threshold/tolerance, as well as McGill Pain Questionnaire qsensory and affective ratings of electric and ischemic stimuli. Electrocutaneous stimulation was also used to assess nociceptive flexion reflex threshold, a physiological measure of spinal nociception.Results: When analyses were limited to data collected only in the targeted menstrual phases (N = 30), results indicated no menstrual phase effect on any pain outcome (all P's > 0.05), with the exception of lower electrocutaneous pain thresholds during the late-luteal phase. No outcomes differed by menstrual phase in the full sample (N = 41). This indicates nociceptive responding varies little between the mid-follicular and late-luteal phases.Discussion: The present study suggests that experimental pain processing does not significantly differ between the mid-follicular and late-luteal phases of the menstrual cycle in healthy women. This implies hormonal variation across these 2 phases (ie, progesterone) has a minimal effect on subjective and physiological responses to pain.