Bartley Emily J, Palit Shreela, Kuhn Bethany L, Kerr Kara L, Terry Ellen L, DelVentura Jennifer L, Rhudy Jamie L
Department of Psychology, University of Tulsa, Tulsa, OK.
Clin J Pain. 2015 Aug;31(8):730-9. doi: 10.1097/AJP.0000000000000153.
OBJECTIVE: Sex differences in pain are well established, with women reporting greater incidence of clinical pain and heightened responsivity to experimental pain stimuli relative to men. Sex hormones (ie, estrogens, progestins, androgens) could contribute to extant differences in pain sensitivity between men and women. Despite this, there has been limited experimental research assessing the relationship between pain and sex hormones. The purpose of this study was to extend previous research and examine the association between sex hormones and nociceptive processing in healthy women. MATERIALS AND METHODS: A total of 40 healthy women were tested during the mid-follicular, ovulatory, and late-luteal phases of the menstrual cycle (testing order counterbalanced). Salivary estradiol, progesterone, and testosterone were collected at each testing session and pain was examined from electrocutaneous threshold/tolerance, ischemia threshold/tolerance, and McGill Pain Questionnaire-Short Form ratings of noxious stimuli. Nociceptive flexion reflex threshold was assessed as a measure of spinal nociception. RESULTS: Overall, there were no significant menstrual phase-related differences in pain outcomes. Nonetheless, variability in testosterone (and to a lesser degree estradiol) was associated with pain; testosterone was antinociceptive, whereas estradiol was pronociceptive. No hormone was associated with nociceptive flexion reflex threshold. DISCUSSION: Although future research is needed to replicate and extend these findings to clinical populations (ie, chronic pain, premenstrual dysphoric disorder), results from the present study indicate that menstrual phase-related changes in sex hormones have minimal influence on experimental pain. However, individual differences in testosterone may play a protective role against pain in healthy women.
目的:疼痛方面的性别差异已得到充分证实,女性报告的临床疼痛发生率更高,且相对于男性,对实验性疼痛刺激的反应性更强。性激素(即雌激素、孕激素、雄激素)可能导致了男性和女性在疼痛敏感性上现存的差异。尽管如此,评估疼痛与性激素之间关系的实验研究仍然有限。本研究的目的是扩展先前的研究,并检验健康女性中性激素与伤害性感受处理之间的关联。 材料与方法:共有40名健康女性在月经周期的卵泡中期、排卵期和黄体后期接受测试(测试顺序平衡)。在每次测试时收集唾液中的雌二醇、孕酮和睾酮,并通过皮肤电阈值/耐受性、缺血阈值/耐受性以及麦吉尔疼痛问卷简表对有害刺激的评分来检测疼痛。评估伤害性屈曲反射阈值作为脊髓伤害性感受的一项指标。 结果:总体而言,疼痛结果在月经周期各阶段之间没有显著差异。尽管如此,睾酮(以及程度较轻的雌二醇)的变化与疼痛相关;睾酮具有抗伤害作用,而雌二醇具有促伤害作用。没有激素与伤害性屈曲反射阈值相关。 讨论:尽管未来需要开展研究以复制这些发现并将其扩展至临床人群(即慢性疼痛、经前烦躁障碍),但本研究结果表明,与月经周期相关的性激素变化对实验性疼痛的影响极小。然而,睾酮的个体差异可能对健康女性的疼痛起到保护作用。
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