Department of Neurology, Philipps University of Marburg, Marburg, Germany. teepker @ med.uni-marburg.de
Neuropsychobiology. 2010;61(3):131-40. doi: 10.1159/000279303. Epub 2010 Jan 29.
The results of studies examining the response to experimental pain during the menstrual cycle are conflicting because of differences in the definitions of the menstrual period, outcome measures and types of experimental pain stimulation. So far, there have been only a few studies correlating experimental pain with the levels of gonadal hormones over the menstrual cycle. Therefore, we assessed the responses to multiple experimental pain stimuli during the menstrual cycle and computed their correlations with the salivary concentrations of the gonadal hormones estrogen and testosterone.
Twenty-four healthy and regularly menstruating women between 20 and 41 years old took part in the study. Detection thresholds (warmth, cold and electrical current) and pain thresholds (cold, heat, pressure and electrical current) were assessed on days 1, 4, 14 and 22 of the menstrual cycle. In each session, salivary samples were collected for the determination of the physiological estrogen 17beta-estradiol, progesterone and testosterone. Progesterone was used exclusively to verify regular menstrual cycling.
Significant variations in pain thresholds for cold, pressure and electrical stimuli were observed over the menstrual cycle with the highest thresholds on day 22, except for the cold pain thresholds, which peaked on day 14. There were no such changes regarding heat pain and all the detection thresholds. The correlations separately computed for each of the 4 days between salivary estrogen as well as testosterone on the one hand and the detection or pain thresholds on the other hand failed to show significant levels, except for the coupling of testosterone and electrical pain thresholds on day 1.
The pain thresholds for all the physical stressors increased after menstruation. The acrophases were located in the follicular (cold pain threshold) or in the luteal phase (pressure and electrical pain thresholds). The results of our correlation analyses indicate only minimal influences of the physiological levels of gonadal hormones on pain sensitivity in women.
由于月经周期的定义、结果测量和实验性疼痛刺激的类型不同，研究实验性疼痛对月经周期的反应的结果相互矛盾。到目前为止，只有少数研究将实验性疼痛与月经周期中性腺激素水平相关联。因此，我们评估了在月经周期中对多种实验性疼痛刺激的反应，并计算了它们与性腺激素雌二醇和睾酮唾液浓度的相关性。
24 名年龄在 20 至 41 岁之间的健康且有规律月经的女性参加了这项研究。在月经周期的第 1、4、14 和 22 天评估了检测阈值（温暖、寒冷和电流）和疼痛阈值（寒冷、热、压力和电流）。在每个阶段，采集唾液样本以确定生理雌激素 17β-雌二醇、孕酮和睾酮。孕酮仅用于验证规律的月经周期。
在月经周期中，冷、压和电流刺激的疼痛阈值存在显著变化，除了冷痛阈值在第 14 天达到峰值外，其余阈值在第 22 天最高。在热痛和所有检测阈值方面没有这种变化。分别计算 4 天中每一个唾液雌二醇和睾酮与检测或疼痛阈值之间的相关性，除了第 1 天睾酮和电流疼痛阈值之间的耦合外，均未显示出显著水平。
所有物理应激源的疼痛阈值在月经后增加。峰值位于卵泡期（冷痛阈值）或黄体期（压力和电流痛阈值）。我们的相关分析结果表明，生理水平的性腺激素对女性的疼痛敏感性只有很小的影响。
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