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[年轻女性月经周期中对缺血性疼痛和压痛的感知。与情绪和皮质醇水平的关联]

[Perception of ischemic and pressing pain in young women during menstrual cycle. Association with humor and cortisol levels].

作者信息

Viana Elizabel de Souza Ramalho, da Silva Selma Bruno, de Sousa Maria Bernardete Cordeiro

机构信息

Programa de Pós-Graduação em Ciências da Saúde-UFRN.

出版信息

Acta Cir Bras. 2005;20 Suppl 1:220-6.

Abstract

PURPOSE

The aim of the present study was to investigate the modulation of pain perception, estimate by both threshold and tolerance to ischemic and pressure stimuli, by cortisol and humor states across the menstrual cycle.

METHODS

Threshold and tolerance pain to ischemic and pressure stimuli were determined in eighteen healthy young women. The menstrual cycle phases were determined using oral temperature, documentation of the first and last day of menstruation and plasma levels of progesterone and estradiol. Statistical analysis using linear regression model (R2) indicate which hormonal variables (estradiol, progesterone and cortisol) and/or variables obtained from the questionnaire Profile of Mood States (POMS) (fatigue, tension, anger, vigor, confusion and depression) explain, isolated or together, each one of the pain parameters during the five phases of the menstrual cycle.

RESULTS

In the follicular, periovulatory, early-to-middle luteal and menstrual phases hormones and subjective variables from POMS explained the responses for pain threshold and tolerance to ischemic and pressure stimulus. Estradiol (during follicular, peri-ovulatory and menstrual phases) and cortisol (during follicular, early-to-mid luteal and mestrual phases) explain only the pain perception to pressure. The differential participation of the hormones in the two types of pain suggests that estradiol, and probably cortisol, modulate the pathways related to pressure but not those related to ischemic pain. On the other hand only the mood states variables explained pain perception during late luteal phase.

CONCLUSIONS

The analysis of hormonal and subjective variables (POMS) together, associated to detailed characterization of the menstrual cycle suggest that participation of estradiol and cortisol modulate pain perception to pressure stimulus but not to ischemic one. Indeed, suggest that in healthy women with regular menstrual cycles, only subjective variables explained pain perception during late luteal phase of menstrual cycle.

摘要

目的

本研究旨在探讨在整个月经周期中,皮质醇和情绪状态对疼痛感知的调节作用,通过缺血和压力刺激的阈值及耐受性来评估疼痛感知。

方法

对18名健康年轻女性测定其对缺血和压力刺激的疼痛阈值及耐受性。通过口腔温度、月经第一天和最后一天的记录以及孕酮和雌二醇的血浆水平来确定月经周期阶段。使用线性回归模型(R²)进行统计分析,以表明哪些激素变量(雌二醇、孕酮和皮质醇)和/或从情绪状态量表(POMS)问卷中获得的变量(疲劳、紧张、愤怒、活力、困惑和抑郁)单独或共同解释月经周期五个阶段中每个疼痛参数。

结果

在卵泡期、排卵期、黄体早期至中期和月经期,POMS中的激素和主观变量解释了对缺血和压力刺激的疼痛阈值及耐受性反应。雌二醇(在卵泡期、排卵期和月经期)和皮质醇(在卵泡期、黄体早期至中期和月经期)仅解释对压力的疼痛感知。激素在两种疼痛类型中的不同参与表明,雌二醇,可能还有皮质醇,调节与压力相关的通路,但不调节与缺血性疼痛相关的通路。另一方面,仅情绪状态变量解释了黄体晚期的疼痛感知。

结论

将激素和主观变量(POMS)结合起来分析,并结合月经周期的详细特征,表明雌二醇和皮质醇的参与调节对压力刺激的疼痛感知,但对缺血性刺激的疼痛感知无调节作用。实际上,这表明在月经周期规律的健康女性中,仅主观变量解释了月经周期黄体晚期的疼痛感知。

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