Heightened cold pain and pressure pain sensitivity in young female adults with moderate-to-severe menstrual pain.
This study investigated the association between menstrual pain severity and psychophysical measures of cold and pressure pain sensitivity. A cross-sectional design was used with young women (n = 432) from the Western Australian Pregnancy Cohort (Raine) Study. Menstrual pain severity and oral contraception use was obtained from questionnaires at 20 and 22-year follow-ups. A visual analog scale (VAS; range from 0 [none] to 10 [unbearable]) was used to measure menstrual pain severity at both 20 and 22 years over the 3-year period, with 3 groups created: (1) no pain or mild pain (VAS 0-3), (2) at least moderate pain at a minimum of 1 of the 2 time points (hereafter named "mixed)", and (3) severe pain (VAS 8-10). Cold pain sensitivity (dorsal wrist) and pressure pain sensitivity (lumbar spine, upper trapezius, dorsal wrist, and tibialis anterior) were assessed using standardised quantitative sensory testing protocols. Confounding variables included number of musculoskeletal pain sites, oral contraceptive use, smoking, physical activity, body mass index, psychological distress, and sleep. Severe menstrual pain and mixed menstrual pain were positively associated with heightened cold pain sensitivity (distant from menstrual pain referral site) and pressure pain sensitivity (local to menstrual pain referral site). These associations remained significant after adjusting for potential confounding variables including multisite musculoskeletal pain. Our findings suggest peripheral and central neurophysiological mechanisms contributing to heightened pain sensitivity in young women with moderate and severe menstrual pain. These data highlight the need for innovative management approaches to attenuate the negative impact of severe menstrual pain in young women.
School of Physiotherapy and Exercise Science, Curtin University, Western Australia, Australia Center for Life Course Epidemiology and Systems Medicine, University of Oulu, Oulu, Finland Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland Arthritis and Osteoporosis, Victoria, Australia Department of Obstetrics and Gynaecology, University of Melbourne and the Royal Women's Hospital, Parkville, Melbourne, Australia School of Population Health, University of Western Australia, Perth, Western Australia, Australia Finnish Institute of Occupational Health, Health and Work Ability, Oulu, Finland.
Helen
H
Slater
Markus
M
Paananen
Anne J
AJ
Smith
Peter
P
O'Sullivan
Andrew M
AM
Briggs
Martha
M
Hickey
Jenny
J
Mountain
Jaro
J
Karppinen
Darren
D
Beales
D001007:Anxiety / Q000453:epidemiology; D015331:Cohort Studies; D003080:Cold Temperature; D003276:Contraceptives, Oral / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology; D004412:Dysmenorrhea / Q000453:epidemiology*; D005260:Female; D006801:Humans; D006930:Hyperalgesia / Q000453:epidemiology* / Q000503:physiopathology; D009043:Motor Activity; D017288:Pain Threshold / Q000502:physiology; D011312:Pressure; D012720:Severity of Illness Index; D012907:Smoking / Q000453:epidemiology; D013315:Stress, Psychological / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014904:Western Australia / Q000453:epidemiology; D055815:Young Adult
D003276:Contraceptives, Oral