Department of Psychology, The University of Tulsa, USA.
Pain. 2010 May;149(2):365-372. doi: 10.1016/j.pain.2010.02.041. Epub 2010 Mar 20.
Research indicates pain may be influenced by the menstrual cycle. While the mechanisms underlying these effects are unclear, it is possible that menstrual phase-related changes in endogenous pain modulation contribute. The present study used well-validated methods to study affective modulation of pain and the nociceptive flexion reflex (NFR) in healthy women during two menstrual phases (mid-follicular vs. late-luteal). Women (N=41) tracked their menstrual phases for three complete cycles and were asked to attend two laboratory testing sessions in the second and third cycles to assess affective modulation of pain and nociception (testing order counterbalanced). Menstrual phase was assessed from daily diaries, luteinizing hormone tests, and basal body temperature. At each session, emotionally charged pictures were presented and suprathreshold electrocutaneous stimulations were delivered during and in between pictures. Subjective and physiological emotional reactions were recorded in response to each picture and pain ratings and NFRs were recorded in response to each suprathreshold stimulus. Results suggested pictures effectively manipulated emotion in both menstrual phases. Moreover, arousing unpleasant pictures enhanced pain and NFR, whereas arousing pleasant pictures inhibited pain and NFR. These modulatory effects were similar in both menstrual phases. Together, these findings suggest that affective engagement of corticospinal mechanisms does not differ across these phases of the menstrual cycle. However, future research is needed to directly assess the relationship between affective modulation of pain/nociception and inter- and intra-individual differences in ovarian hormones and to extend these findings to women who suffer from menstrual cycle-related pain (e.g., premenstrual dysphoric disorder, fibromyalgia).
研究表明疼痛可能受到月经周期的影响。虽然这些影响的机制尚不清楚，但月经周期相关的内源性疼痛调节变化可能是原因之一。本研究使用了经过充分验证的方法，在两个月经周期（中卵泡期与晚黄体期）中研究了健康女性的疼痛和伤害性屈反射（NFR）的情感调节。女性（N=41）连续三个周期记录月经周期，并被要求在第二个和第三个周期参加两次实验室测试，以评估疼痛和伤害性感受的情感调节（测试顺序平衡）。月经周期通过每日日记、促黄体激素测试和基础体温进行评估。在每次测试中，呈现情绪激动的图片，并在图片之间和期间进行超阈值电刺激。记录每个图片的主观和生理情绪反应，以及每个超阈值刺激的疼痛评分和 NFR。结果表明，在两个月经周期中，图片都能有效地调节情绪。此外，令人兴奋的不愉快图片增强了疼痛和 NFR，而令人兴奋的愉快图片抑制了疼痛和 NFR。这些调节效应在两个月经周期中相似。总的来说，这些发现表明，皮质脊髓机制的情感参与在月经周期的这些阶段没有差异。然而，需要进一步的研究来直接评估疼痛/伤害性感受的情感调节与卵巢激素的个体间和个体内差异之间的关系，并将这些发现扩展到患有与月经周期相关的疼痛的女性（例如经前烦躁障碍、纤维肌痛）。
