Abstract
This study investigated if conditioned pain modulation (CPM) varies across the menstrual
cycle in healthy, normally menstruating women and investigated correlations between
sex hormone levels and CPM across the menstrual cycle. Thirty-six normally menstruating
women were tested during 3 phases of the menstrual cycle: early follicular, ovulatory,
and midluteal, confirmed by hormone determinations. Mechanical pressure (test stimulus)
was applied to the masseter muscle and the induced pain assessed before, during, and
after immersion of the hand into ice water (conditioning stimulus) to activate CPM
or tepid water (control). Conditioning pain, ie, pain in the hand during CPM/control
experiment, and tolerance time were also measured. Test pain intensity was suppressed
during CPM in all phases (P < .001), but with more effective suppression during the ovulatry than during the
early follicular phase (P < .05). There were no changes in test pain intensity during the control experiment
and no significant differences in conditioning pain, or tolerance time between phases.
In conclusion, our results showed more effective pain modulation in the ovulatory
phase of the menstrual cycle, when estradiol levels are high and progesterone levels
are low, than in the early follicular phase when both these hormones are low.
Perspective
Deficient pain modulation is believed to be an important pathogenic factor in many
chronic pain conditions that affect women. This article shows that sex hormones modulate
conditioned pain modulation, because pain inhibition was more effective in the ovulatory
phase of the menstrual cycle than in the early follicular phase.
Key words
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Article info
Publication history
Published online: May 28, 2012
Accepted:
April 3,
2012
Received in revised form:
March 18,
2012
Received:
December 13,
2011
Footnotes
Supported by funds from the Swedish Research Council K2009-52X-20944-01-1 (M.E.), and 20324 (A.L.H.), Karolinska Institutet, the Stockholm County Council, and the Swedish Dental Association.
The authors do not have any financial relationships that might lead to a conflict of interest.
Identification
Copyright
© 2012 American Pain Society. Published by Elsevier Inc. All rights reserved.
