Thu. January 5th, 2012
Vol.2, Issue 1

Period Pain and Low Pain Threshold

There are generally two types of pain associated with "dysmenorrhea" (difficult or painful periods). These are referred to as primary dysmenorrhea and secondary dysmenorrhea. The word "secondary" means symptoms are a consequence of an underlying disease such as endometriosis, ovarian cysts, fibroids, etc. Primary dysmenorrhea refers to symptoms that occur during menstruation without obvious associated disease states.

The causes of period pain in primary dysmenorrhea remain somewhat clouded. However, recent research by University of Oxford researchers has shed new light on knowledge of the characteristics and potential significance of period pain (Dr. K. Vincent and colleagues).The research involved investigation of pain thresholds of otherwise healthy women, with or without period pain.

The causes of period pain in primary dysmenorrhea remain somewhat clouded. However, recent research by University of Oxford researchers has shed new light on knowledge of the characteristics and potential significance of period pain (Dr. K. Vincent and colleagues).The research involved investigation of pain thresholds of otherwise healthy women, with or without period pain.

In experiments, a heated plate was applied to skin to induce pain. Those who suffered from period pain experienced more pain and discomfort from lesser degrees of thermal (heat) application, compared to women who did not have period pain. In other words, women without period pain were more robust in terms of their lack of pain perception than those with period pain. Moreover, women with period pain were more sensitive to pain induction and had a lower pain threshold.

What do these findings mean? It was suggested that women with period pain have more "pain problems," in general. Therefore, the management of period pain may reduce overall debility from "body pain." I believe these studies demonstrate the power of "body-mind" functions.

Primary dysmenorrhea is often treated by pain killers (analgesics, e.g. ibuprofen) or low-dose contraceptive pills. However, addressing mind-body issues with behavioral interventions, such as the induction of relaxation responses, biofeedback training or positive visualization (modified hypnosis) seem to be an obvious, simple, gentle and natural approach to period pain and general pain management.

While studies on period pain seem to be revealing, the phenomena they probe are not new or novel issues in medicine. There have been studies on other conditions linked to mind-body functions. Perhaps the most common is irritable bowel syndrome (IBS), which affects as many as 25 million Americans and is more common in women than men.

With IBS, abdominal pain can be associated with altered bowel habits and other distressing symptoms. This classic mind-body (gut-mind) disorder has been shown to be related to an enhanced sensitivity to pain. Modified hypnosis, relaxation and behavioral treatments have been reported to be more effective than standard medical treatments for pain or colic in IBS.

The medical world is moving toward a better understanding of the harmonious functions of the body, especially mind-body connections. Disturbances of function (functional diseases) are primary targets for many alternative medical interventions (e.g. relaxation responses, yoga, music therapy, etc.). These approaches are emerging with an evidence base in the practice of Integrative Medicine.

Herbs and natural substances, such as black cohosh or soy isoflavones-which are used in traditional herbal medicine to address female-specific issues-may also offer benefits. Herbs are not actual pain killers (analgesics), but they may exert indirect benefits on period pain and premenstrual syndrome (PMS). Observations of pain control have also been noted with curcuminoids, derived from curcumin (turmeric).

There are many reasons to seek alternative strategies to manage chronic pain, and I raise these issues to make my readers aware of information that is often overlooked in practices of prescription or over-the-counter use of pain-killing medication. Many drugs are merely band-aids for pain, and a holistic approach is required.

This knowledge underscores the importance of the recent observations of difference in pain appreciation or pain thresholds that differ greatly among different people. Pain is part of the lack of harmony of body functions.

Be Healthy!
Dr. Stephen Holt, M.D.

Dr. Stephen Holt, M.D. is a Distinguished Professor of Medicine (Emerite) and a medical practitioner in New York State. He has published many peer-review papers in medicine and he is a best-selling author with more than twenty books in national and international distribution. He has received many awards for teaching and research. Dr. Holt is a frequent lecturer at scientific meetings and healthcare facilities throughout the world. He is the founder of the Holt Institute of Medicine (www.hiom.org) and www.stephenholtmd.com