Abdominal skeletal muscle activity precedes spontaneous menstrual cramping pain in primary dysmenorrhea

Oladosu, Folabomi A.; Tu, Frank F.; Farhan, Saaniya; Garrison, Ellen F.; Steiner, Nicole; Roth, Genevieve E.; Hellman, Kevin M.

doi:10.1016/j.ajog.2018.04.050

Cited by 17 publications

(15 citation statements)

References 33 publications

(37 reference statements)

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“…However, a major limitation of existing research is that it remains unclear whether enhanced pain sensitivity develops as a function of repeated episodes of pain or whether these differences in girls with PD may reflect a more stable, central sensitization to pain. Ongoing research has begun to identify genetic [11; 48], physiological [28], and symptom-based phenotypes [6] in women with PD; however, further research in this area is warranted, particularly with adolescents within the first 2-3 yeas of starting menstruation, to clearly determine how, when, and for whom these alterations develop.…”

Section: Discussionmentioning

confidence: 99%

Experimental evaluation of central pain processes in young women with primary dysmenorrhea

Payne

Seidman

Sim³

et al. 2019

PAIN

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Menstrual pain without an underlying medical condition, known as primary dysmenorrhea (PD), is the leading cause of school and work absences [9], and up to 50% of adolescent girls with dysmenorrhea report impaired functioning because of their symptoms [15]. Despite this high prevalence, there is limited research on how and why many adolescent girls and young women experience disabling menstrual pain. Past research has demonstrated enhanced pain sensitivity in women with dysmenorrhea, both in areas of referred pain [3; 5; 12; 21; 35; 44; 46] and remote body regions [1; 2; 4; 5; 12; 13; 17; 20; 21; 23; 35; 46]. These data provide support for the concept that PD is associated with lasting changes in pain processing. However, little is known about potential mechanisms in this episodic condition. New test paradigms such as temporal summation (TS) and conditioned pain modulation (CPM) examine both excitatory and inhibitory central pain processes, respectively. It is hypothesized that the presence of TS reflects central sensitization, where by pain responses become exaggerated over time despite the pain stimulus remaining at a constant level [16; 32; 40]. Chronic pain populations show elevated TS compared to healthy populations, a difference that suggests overactive excitatory pain responses [33; 36]. In women with PD, one study also found evidence of TS following repeated cervical distensions-a pattern that was not evident in women without PD [3]. CPM, on the other hand, is a measure of inhibitory pain processes, and deficits in CPM may reflect impairments in central descending inhibitory systems posited as an underlying mechanism in chronic pain [45; 52]. CPM has been evaluated in other episodic pain conditions (i.e., migraine headaches), with some studies showing deficient CPM compared

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Section: Discussionmentioning

confidence: 99%

Experimental evaluation of central pain processes in young women with primary dysmenorrhea

Payne

Seidman

Sim³

et al. 2019

PAIN

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“…Participants included in this study were enrolled between March 2015 and November 2017. Some participant data from the MRI and ultrasound study has already been published 6, 7 . The method in this paper was used in those prior studies 6, 7 to investigate the role of uterine contractions and abdominal muscle activity in menstrual pain.…”

Section: Methodsmentioning

confidence: 99%

“…To validate a new metric for evaluating spontaneous pain and its temporal characteristics, we investigated women with menstrual period pain, clinically known as dysmenorrhea. Previously, a hand‐held squeeze bulb was used to characterize the temporal relationship between cramping pain and uterine activity with magnetic resonance imaging (MRI) 6 or abdominal muscle activity with Electromyography, 7 however, this method to measure pain intensity was not validated. We tested the hypothesis that worse global self‐reported rating of menstrual cramping pain is associated with more prolonged, intense, and frequent bulb squeezing pain bouts in women with dysmenorrhea.…”

Section: Introductionmentioning

confidence: 99%

Development and validation of a real‐time method characterizing spontaneous pain in women with dysmenorrhea

Kantarovich

Dillane

Garrison

et al. 2021

J of Obstet and Gynaecol

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Aim Prior research has primarily focused on static pain assessment, largely ignoring the dynamic nature of pain over time. We used a novel assessment tool for characterizing pain duration, frequency, and amplitude in women with dysmenorrhea and evaluated how these metrics were affected by naproxen treatment. Methods Dysmenorrheic women (n = 25) rated their menstrual pain by squeezing a pressure bulb proportional to the magnitude of their pain. To evaluate whether bulb squeezing was affected by naproxen, we compared parameters before and after naproxen. We also analyzed the correlation between pain relief on a numerical rating scale to changes in bulb squeezing parameters. Random bulb‐squeezing activity in pain‐free participants (n = 14) was used as a control for nonspecific effects or bias. Results In dysmenorrheic women, naproxen reduced the duration of the squeezing during a painful bout, the number of painful bouts and bout intensity. Before naproxen, the correlation between these bulb squeeze parameters and self‐reported pain on numeric rating scale was not significant (R2 = 0.12, p = 0.304); however, there was a significant correlation between changes in bulb squeeze activity and self‐reported pain relief after naproxen (R2 = 0.55, p < 0.001). Conclusion Our study demonstrates a convenient technique for continuous pain assessment, capturing three different dimensions: duration, frequency, and magnitude. Naproxen may act by reducing the duration and frequency of episodic pain in addition to reducing the severity. After further validation, these methods could be used for other pain conditions for deeper phenotyping and assessing novel treatments.

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“…Several authors argued that PD may contribute to the development of a chronic pelvic pain disorder [1,2], showing high comorbidity with other chronic pain conditions, such as irritable bowel syndrome, migraines and fibromyalgia [10]. Nevertheless, since only 75%-80% of women treated with pharmacology experienced relief from PD symptoms, it is suggested that the nociceptive mechanisms underlying PD are not yet understood [11].…”

Section: Introductionmentioning

confidence: 99%

“…In addition, Blakey et al [14] assume that PD can be caused by a dyssynergy between the muscles of the pelvic cavity and the soft tissues. Some treatments proposed to manage PD, such as heat, massage, Transcutaneous electrical nerve stimulation (TENS) or vertebral manipulations, could plausibly address the dysfunction of the abdominal muscles [11,15,16]. Nevertheless, few research studies have been conducted establishing associations between the abdominal muscles and PD.…”

Section: Introductionmentioning

confidence: 99%

Ultrasound Assessment of the Abdominal Wall Muscles in Women with and without Primary Dysmenorrhea: A Cross-Sectional Study

et al. 2020

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Background: Primary dysmenorrhea (PD) is one of the most common gynecological disorders in women of reproductive age that may affect quality of life. It is believed that the underlying cause of PD may be the excessive production of prostaglandins (PGs), however, between 20%–25% of women with PD did not respond to pharmacological treatments, showing that nociceptive mechanisms underlying PD are still not understood. The purpose of this study was to measure and compare, through the use of ultrasound imaging, the thickness at rest of the abdominal wall, as well as the interrecti distance (IRD), in women with and without PD. Methods: A cross-sectional study has been performed using ultrasound imaging (USI) to measure the resting thickness of the external oblique (EO), internal oblique (IO), transversus abdominis (TrAb), rectus abdominis (RA), as well as the IRD in a sample of 39 women, 19 with PD and 20 without PD (median ± IR age: 20 ± 4 and 22.5 ± 7 years, respectively). Results: Findings of muscular thickness did not reveal statically significant differences (p < 0.05) in EO, IO, TrAb, RA, and the IRD between the PD group and control group. Conclusions: These findings suggest that the thickness of the abdominal wall is not associated with PD.

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Abdominal skeletal muscle activity precedes spontaneous menstrual cramping pain in primary dysmenorrhea

Cited by 17 publications

References 33 publications

Experimental evaluation of central pain processes in young women with primary dysmenorrhea

Experimental evaluation of central pain processes in young women with primary dysmenorrhea

Development and validation of a real‐time method characterizing spontaneous pain in women with dysmenorrhea

Ultrasound Assessment of the Abdominal Wall Muscles in Women with and without Primary Dysmenorrhea: A Cross-Sectional Study

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