Association of pain catastrophizing with pain processing across the menstrual cycle in healthy women

Pain catastrophizing is associated with enhanced pain outcomes, but little is known about whether the catastrophizing and pain relationship changes across menstrual phases. The present study assessed the relationship between state (i.e., situation-specific) and trait (i.e., traditional) pain catastrophizing and pain sensitivity in 54 healthy women during the mid-follicular, ovulatory, and late-luteal phases, which were verified by salivary sex hormone levels. Pain sensitivity was assessed from electric pain threshold/tolerance, nociceptive flexion reflex threshold (NFR; measure of spinal nociception), suprathreshold pain ratings, ischemia pain threshold/tolerance, and sensory and affective ratings of electric and ischemia stimuli. Trait catastrophizing was measured on a day prior to any laboratory pain testing, whereas state catastrophizing was assessed at each phase after delivery of painful electric stimuli. Results indicated that state catastrophizing was positively related to affect ratings for electric and ischemic pain (p<.05). However, there was also a Menstrual Phase X State Catastrophizing interaction for affect ratings to electric stimuli (p<.05), indicating that there was a stronger positive relationship between state catastrophizing and affect ratings during the ovulation phase than the late-luteal phase. There were also significant Menstrual Phase X Trait Catastrophizing and Menstrual Phase X State Catastrophizing interactions for NFR threshold (ps<.05). Trait catastrophizing had a stronger negative relationship with NFR threshold during the ovulation phase than the luteal phase, whereas state catastrophizing had a stronger positive relationship with NFR threshold during the ovulation phase than the late-luteal phase (p<.05). A significant Menstrual Phase X State Catastrophizing interaction for suprathreshold pain ratings (p<.05) indicated state catastrophizing had a stronger positive relationship with suprathreshold ratings during the ovulation phase than the late-luteal phase. Together, state catastrophizing was generally a stronger correlate of pain outcomes than trait catastrophizing and some relationships were moderated by menstrual cycle phase.