Effect of the menstrual cycle on pain experience associated with periodontal therapy

Objectives: The aim of this pilot cross-over study was to compare preliminarily the pain perception of female patients undergoing periodontal debridement during menstrual or pre-menstrual phases (peri-menstrual period) with that observed during mid-menstrual phase (post-menstrual period). Materials and Methods: Twenty women with moderate-to-advanced chronic periodontitis and regular menstrual cycles were asked to complete Corah's Dental Anxiety Scale (DAS) during the first debridement visit. Patients were randomly assigned to receive their first debridement visit during either their peri-menstrual or post-menstrual period. Debridement was performed in bilateral quadrants of patients during the periods. Pain levels for each quadrant were asssessed with a Visual Analogue Scale (VAS), after each debridment visit. Results: There was no significant correlation of order of treatment in the intensity of perceived pain during the periods (p < 0.05). The median VAS scores were 22.0 and 15.2mm in the peri-menstrual and the post-menstrual period, respectively. Increase in pain perception among females during their peri-menstrual period was significantly greater than their post-menstrual period (p < 0.05). Conclusion: No clinical conclusions can be drawn at this stage as this pilot study did not have a sufficiently broad population to generalize these observations to all female periodontal patients. Providing clinicians with information about patients' menstrual cycle during debridement can alter the pain experience.