Circulating sex steroids and bladder pain sensitivity in dysmenorrhea

Molecular Pain

Katlyn E Dillane¹  Genevieve E Roth¹  Ellen F Garrison¹  Kevin M Hellman²  Folabomi A Oladosu²  Frank F Tu² 

[1] Department of Obstetrics & Gynecology, Northshore University HealthSystem, Evanston, IL, USA;Department of Obstetrics & Gynecology, Northshore University HealthSystem, Evanston, IL, USA;Pritzker School of Medicine, University of Chicago, Chicago, IL, USA;

关键词: Dysmenorrhea;    estradiol;    quantitative sensory testing;    sex hormone-binding globulin;   

DOI  :  10.1177/17448069211035217

来源: Sage Journals

【 摘 要 】

Although elevated estradiol levels facilitate chronic pelvic pain in animal models, it remains to be determined whether sex steroid levels are altered in a cross-section of women with chronic pelvic pain (CPP) and those at-risk for developing CPP. We sought to determine if sex steroid levels are increased in women with menstrual pain and whether those changes were more extreme in two groups of women with worsened pelvic pain profiles: a) dysmenorrhea plus evidence of bladder pain sensitivity and b) bladder pain syndrome. Serum samples were collected during the mid-luteal phase to measure estradiol, progesterone, testosterone, and sex hormone-binding globulin. We also compared quantitative sensory testing profiles to evaluate how sex steroid differences influence proposed pain sensitivity mechanisms. Women with combined dysmenorrhea and bladder sensitivity had higher estradiol concentrations than controls (487 [IQR 390 – 641] vs 404 [336 – 467] pmol/L, p = 0.042). Bladder pain syndrome participants had greater sex hormone-binding globulin than controls (83 [71 – 108] vs 55 [42 – 76 nmol/L; p = 0.027). Levels of pain sensitivity and mood were different across the groups, but the only significant relationship to sex steroids was that sex hormone-binding globulin was correlated to somatic symptoms (r = 0.26, p = 0.03). These findings show women potentially at-risk for CPP and women with diagnosed CPP exhibit altered circulating levels of sex steroids. Because these hormonal differences appear to be independent of mood or pain sensitivity, the role of sex steroids in the emergence of CPP may be via sensitization of visceral afferents.

【 授权许可】

Unknown