Low-dose progestin-releasing contraceptives are associated with a higher pain threshold in healthy women.
OBJECTIVE
To determine the pain thresholds of women taking different formulations of hormonal contraceptives.


METHODS
Cross-sectional study.


METHODS
Basic health care unit.


METHODS
Eighty-nine healthy nonusers and 188 users of hormonal contraceptives.


METHODS
Subject interviews were followed by the application of a semistructured questionnaire, including a psychometric assessment with the Beck Depression Inventory and the State-Trait Anxiety Inventory. After the interview, a 10-mL peripheral blood sample was collected. Pain thresholds were obtained by performing pressure algometry.


METHODS
Serum concentrations of E2, P, and T (free fraction) were determined via chemoluminescence. The menstrual cycle phase was determined according to hormonal level and identification of an LH surge in urine. Pain threshold was evaluated with a dynamometer applied to the forearm skin of the nondominant limb and abdominal wall.


RESULTS
Progestin-only contraceptive users showed a higher pain pressure threshold in the forearm (2.94 ± 0.96 vs. 2.74 ± 0.89 vs. 2.62 ± 0.92) and right (2.11 ± 0.87 vs. 1.83 ± 0.81 vs. 1.78 ± 0.77) and left abdomen (2.12 ± 0.88 vs. 1.79 ± 0.76 vs. 1.73 ± 0.70) than did combined hormonal contraceptive users and nonusers of hormonal contraceptives, respectively. Users of contraceptives that continuously release etonogestrel (subcutaneous implant, vaginal ring) or levonorgestrel (intrauterine devices) had higher pain thresholds.


CONCLUSIONS
Women who used hormonal contraceptives enabling continuous release of etonogestrel or levonorgestrel tended to have higher pain thresholds than did nonusers of hormonal contraceptives.
Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil.
Manuela Menezes
MM
Máximo
Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil.
Patrícia Silveira
PS
Silva
Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil.
Carolina Sales
CS
Vieira
Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil.
Thaís Mangetti
TM
Gonçalvez
Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil.
Júlio Cesar
JC
Rosa-E-Silva
Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil.
Francisco José
FJ
Candido-Dos-Reis
Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil.
Antonio Alberto
AA
Nogueira
Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil. Electronic address: polineto@fmrp.usp.br.
Omero Benedicto
OB
Poli-Neto
D000328:Adult; D016022:Case-Control Studies; D003271:Contraceptive Agents, Female / Q000008:administration & dosage* / Q000009:adverse effects; D003277:Contraceptives, Oral, Combined / Q000008:administration & dosage; D003278:Contraceptives, Oral, Hormonal / Q000008:administration & dosage; D003430:Cross-Sectional Studies; D017135:Desogestrel / Q000008:administration & dosage; D004343:Drug Implants; D004958:Estradiol / Q000097:blood; D005260:Female; D006801:Humans; D007436:Intrauterine Devices, Medicated; D016912:Levonorgestrel / Q000008:administration & dosage; D007986:Luteinizing Hormone / Q000097:blood; D008525:Medroxyprogesterone / Q000008:administration & dosage; D008597:Menstrual Cycle / Q000187:drug effects*; D010147:Pain Measurement; D017288:Pain Threshold / Q000187:drug effects*; D011312:Pressure; D011374:Progesterone / Q000097:blood; D011372:Progestins / Q000008:administration & dosage* / Q000097:blood; D011594:Psychometrics; D011795:Surveys and Questionnaires; D013739:Testosterone / Q000097:blood; D055815:Young Adult
D003271:Contraceptive Agents, Female; D003277:Contraceptives, Oral, Combined; D003278:Contraceptives, Oral, Hormonal; D004343:Drug Implants; D011372:Progestins; D013739:Testosterone; D011374:Progesterone; D004958:Estradiol; D016912:Levonorgestrel; D017135:Desogestrel; D007986:Luteinizing Hormone; D008525:Medroxyprogesterone
Hormonal contraceptives; etonogestrel; levonorgestrel; pain threshold