This study investigated the association between
menstrual pain severity and psychophysical measures of cold and pressure
pain sensitivity. A cross-sectional design was used with young women (n = 432) from the Western Australian Pregnancy Cohort (Raine) Study.
Menstrual pain severity and oral
contraception use was obtained from questionnaires at 20 and 22-year follow-ups. A visual analog scale (VAS; range from 0 [none] to 10 [unbearable]) was used to measure
menstrual pain severity at both 20 and 22 years over the 3-year period, with 3 groups created: (1) no
pain or mild
pain (VAS 0-3), (2) at least moderate
pain at a minimum of 1 of the 2 time points (hereafter named "mixed)", and (3) severe
pain (VAS 8-10). Cold
pain sensitivity (dorsal wrist) and pressure
pain sensitivity (lumbar spine, upper trapezius, dorsal wrist, and tibialis anterior) were assessed using standardised quantitative sensory testing protocols. Confounding variables included number of
musculoskeletal pain sites,
oral contraceptive use, smoking, physical activity, body mass index, psychological distress, and sleep. Severe
menstrual pain and mixed
menstrual pain were positively associated with heightened cold
pain sensitivity (distant from
menstrual pain referral site) and pressure
pain sensitivity (local to
menstrual pain referral site). These associations remained significant after adjusting for potential confounding variables including multisite
musculoskeletal pain. Our findings suggest peripheral and central neurophysiological mechanisms contributing to heightened
pain sensitivity in young women with moderate and severe
menstrual pain. These data highlight the need for innovative management approaches to attenuate the negative impact of severe
menstrual pain in young women.