Department of Psychology, The University of Tulsa, Tulsa, OK 74104, USA.
Clin J Pain. 2013 Feb;29(2):154-61. doi: 10.1097/AJP.0b013e31824c5edb.
OBJECTIVES: Understanding the relationship between the menstrual cycle and pain can contribute significantly to our knowledge of pain processing in women. Many early studies suggested that pain sensitivity was enhanced during the luteal phase of the menstrual cycle relative to the follicular phase; however, these studies were often limited by small sample sizes, lack of ovulation verification, focus on a single pain modality, inadequate assessment of menstrual cycle regularity, and low-powered statistical methods. The current study was designed to address these limitations and examine the difference in pain processing between the mid-follicular (days 5 to 8) and late-luteal (days 1 to 6 preceding menses) phases. METHODS: Forty-one healthy, regularly cycling women attended testing sessions that measured pain sensitivity from mechanical pain threshold, electrocutaneous pain threshold/tolerance, and ischemia pain threshold/tolerance, as well as McGill Pain Questionnaire qsensory and affective ratings of electric and ischemic stimuli. Electrocutaneous stimulation was also used to assess nociceptive flexion reflex threshold, a physiological measure of spinal nociception. RESULTS: When analyses were limited to data collected only in the targeted menstrual phases (N=30), results indicated no menstrual phase effect on any pain outcome (all P's>0.05), with the exception of lower electrocutaneous pain thresholds during the late-luteal phase. No outcomes differed by menstrual phase in the full sample (N=41). This indicates nociceptive responding varies little between the mid-follicular and late-luteal phases. DISCUSSION: The present study suggests that experimental pain processing does not significantly differ between the mid-follicular and late-luteal phases of the menstrual cycle in healthy women. This implies hormonal variation across these 2 phases (ie, progesterone) has a minimal effect on subjective and physiological responses to pain.
目的:了解月经周期与疼痛之间的关系,有助于深入理解女性疼痛处理机制。许多早期研究表明,与卵泡期相比,黄体期女性的疼痛敏感性增强;然而,这些研究往往受到样本量小、缺乏排卵验证、关注单一疼痛模式、月经周期规律评估不足以及统计方法效能低等因素的限制。本研究旨在解决这些局限性,并研究中卵泡期(月经第 5-8 天)和黄体晚期(月经前 1-6 天)之间疼痛处理的差异。
方法:41 名健康、月经周期规律的女性参加了测试,测试中使用机械疼痛阈值、电皮肤痛觉阈值/耐痛阈和缺血性疼痛阈值/耐痛阈,以及麦吉尔疼痛问卷 q 感觉和电刺激与缺血性刺激的情感评分,来测量疼痛敏感性。还使用电皮肤刺激来评估伤害性屈反射阈值,这是一种评估脊髓伤害感受的生理指标。
结果:当分析仅限于靶向月经周期内收集的数据时(N=30),结果表明,除黄体晚期的电皮肤痛觉阈值较低外,任何疼痛结果均不受月经周期阶段的影响(所有 P 值均>0.05)。在全样本(N=41)中,没有任何结果因月经周期阶段而异。这表明在中卵泡期和黄体晚期,伤害性反应差异很小。
讨论:本研究表明,健康女性在月经周期的中卵泡期和黄体晚期,实验性疼痛处理没有明显差异。这意味着这两个阶段(即孕激素)的激素变化对疼痛的主观和生理反应影响很小。
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