Iacovides S, Avidon I, Baker F C
Brain Function Research Group, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Eur J Pain. 2015 Jul;19(6):797-804. doi: 10.1002/ejp.604. Epub 2014 Oct 15.
Monthly primary dysmenorrhoeic pain is associated with increased sensitivity to painful stimuli, particularly in deep tissue. We investigated whether women with dysmenorrhoea, compared with controls, have increased sensitivity to experimentally induced deep-tissue muscle ischaemia in a body area distant from that of referred menstrual pain.
The sub-maximal effort tourniquet test was used to induce forearm ischaemia in 11 women with severe dysmenorrhoea and in nine control women both during menstruation and in the follicular phase of the menstrual cycle. Von Frey hair assessments confirmed the presence of experimental ischaemia. Women rated the intensity of menstrual and ischaemic pain on a 100-mm visual analogue scale.
Women with dysmenorrhoea [mean (SD): 68 (20) mm] reported significantly greater menstrual pain compared with controls [mean (SD): 2 (6) mm; p = 0.0001] during the menstruation phase. They also rated their forearm ischaemic pain as significantly greater than the controls during the menstruation [dysmenorrhoeics vs. controls mean (SD): 58 (19) mm vs. 31 (21) mm, p < 0.01] and follicular [dysmenorrhoeics vs. controls mean (SD): 60 (18) mm vs. 40 (14) mm, p < 0.01] phases of the menstrual cycle.
These data show that compared with controls, women who experience severe recurrent dysmenorrhoea have deep-tissue hyperalgesia to ischaemic pain in muscles outside of the referred area of menstrual pain both during the painful menstruation phase and pain-free follicular phase. These findings suggest the presence of long-lasting changes in muscle pain sensitivity in women with dysmenorrhoea. Our findings that dysmenorrhoeic women are hyperalgesic to a clinically relevant, deep-muscle ischaemic pain in areas outside of referred menstrual pain confirm other studies showing long-lasting changes in pain sensitivity outside of the painful period during menstruation.
每月的原发性痛经疼痛与对疼痛刺激的敏感性增加有关，尤其是在深部组织中。我们调查了与对照组相比，痛经女性对实验诱导的远离经痛牵涉部位的身体区域深部组织肌肉缺血的敏感性是否增加。
采用次最大努力止血带试验，在11名严重痛经女性和9名对照女性的月经期间及月经周期的卵泡期诱导前臂缺血。用von Frey毛发评估法确认实验性缺血的存在。女性用100毫米视觉模拟量表对月经疼痛和缺血性疼痛的强度进行评分。
在月经期，痛经女性[平均（标准差）：68（20）毫米]报告的月经疼痛明显比对照组[平均（标准差）：2（6）毫米；p = 0.0001]更严重。在月经周期的月经期[痛经组与对照组平均（标准差）：58（19）毫米对31（21）毫米，p < 0.01]和卵泡期[痛经组与对照组平均（标准差）：60（18）毫米对40（14）毫米，p < 0.01]，她们对前臂缺血性疼痛的评分也明显高于对照组。
这些数据表明，与对照组相比，经历严重复发性痛经的女性在痛经期和无痛卵泡期，在月经痛牵涉区域以外的肌肉中对缺血性疼痛均存在深部组织痛觉过敏。这些发现表明痛经女性的肌肉疼痛敏感性存在长期变化。我们发现痛经女性对月经痛牵涉区域以外临床上相关的深部肌肉缺血性疼痛存在痛觉过敏，这证实了其他研究显示的在月经期间疼痛期以外疼痛敏感性的长期变化。
