Exploring the effect of hormonal contraceptives on pain modulation and cortisol concentration in premenopausal women
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Citation
Abstract
BACKGROUND: Hormonal contraceptives are known to be efficacious interventions for the treatment of dysmenorrhea, or menstrual pain. Additionally, estradiol and progestin can contribute to the cross-regulation that occurs between the Hypothalamic-Pituitary-Adrenal (HPA) and Hypothalamic-Pituitary-Gonadal axes. This study aimed to identify relationships between hair cortisol concentration (the main regulator and product of the HPA axis), menstrual pain, and a paradigm exploring descending pain inhibition, known as conditioned pain modulation (CPM).
METHODS: The sample included 19 cisgender premenopausal women aged 18 years or older without any significant pain or medical history who were not taking illicit drugs. Participants were divided into two cohorts depending on whether they were naturally cycling or using hormonal contraception. Hair samples were collected from each participant and sent to an external lab for cortisol analysis. Participants were also asked to rate their average menstrual pain on a scale of 0 to 10. CPM was assessed through utilization of various pressure and cold pain stimuli.
RESULTS: No statistically significant results were found between the two cohorts for menstrual pain (U = 21.00, p = .083), hair cortisol concentration (t(15) = -.835, p = .417), or CPM (t(17) = -.701, p = .493). There was a significant positive relationship between menstrual pain and CPM, rs(17) = .507, p = .027.
CONCLUSION: The significant relationship between menstrual pain and CPM aligns with previous studies, indicating that menstrual pain may be influenced by neuronal inhibition. The lack of significant group differences between menstrual pain and hair cortisol concentration highlights the complex role of stress in pain expression. Furthermore, this study creates the basis for further investigation into these relationships with a larger cohort and greater focus on the type of hormonal contraception.
Description
2025
License
Attribution 4.0 International