Journal
PAIN
Volume 155, Issue 12, Pages 2448-2460Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1016/j.pain.2014.08.027
Keywords
Chronic pain; Migraine headache; Temporomandibular joint disorder; Irritable bowel syndrome; Fibromyalgia; Chronic pelvic pain; Ovarian hormones; Menstrual cycle
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Funding
- IMPART (Intersections of Mental Health Perspectives in Addictions Research Training)
- H. David Archibald Queen Elizabeth II-Graduate Student Scholarship Training Fellowship
- Carol Mitchell & Richard Venn Graduate Student Fellowship in Women's Mental Health from Women's College Hospital
- Wasser Pain Management Centre, Mt. Sinai Hospital
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Most chronic noncancer pain (CNCP) conditions are more common in women and have been reported to worsen, particularly during the peak reproductive years. This phenomenon suggests that ovarian hormones might play a role in modulating CNCP pain. To this end, we reviewed human literature aiming to assess the potential role of ovarian hormones in modulating the following CNCP conditions: musculoskeletal pain, migraine headache, temporal mandibular disorder, and pelvic pain. We found 50 relevant clinical studies, the majority of which demonstrated a correlation between hormone changes or treatments and pain intensity, threshold, or symptoms. Taken together, the findings suggest that changes in hormonal levels may well play a role in modulating the severity of CNCP conditions. However, the lack of consistency in study design, methodology, and interpretation of menstrual cycle phases impedes comparison between the studies. Thus, while the literature is highly suggestive of the role of ovarian hormones in modulating CNCP conditions, serious confounds impede a definitive understanding for most conditions except menstrual migraine and endometriosis. It may be that these inconsistencies and the resulting lack of clarity have contributed to the failure of hormonal effects being translated into medical practice for treatment of CNCP conditions. (c) 2014 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.
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