Pain Sensitivity in Women with Premenstrual Dysphoric Disorder: A Preliminary Report

Abstract

Objective: An impairment in endogenous opioid and/or serotonergic activity during the luteal phase may play a role in the etiology of premenstrual dysphoric disorder (PDD). This study tested the hypothesis that because of these alterations, PDD patients would exhibit greater pain sensitivity than non-PDD controls when tested during the luteal phase of their menstrual cycles. Participants: Seven subjects prospectively diagnosed with PDD and 11 healthy controls participated in the experiment. Design: After completing the Prospective Report of the Impact and Severity of Menstrual Symptoms (PRISM) calendar for 2 months for diagnostic purposes, all subjects underwent thermal and ischemic pain testing during the luteal phase of their menstrual cycles. Results: PDD subjects were significantly more sensitive to ischemic pain than were controls, with PDD subjects exhibiting lower ischemic pain onset and ischemic pain tolerance. PDD subjects also described their ischemic pain as more intense than did controls. No differences in thermal pain perception emerged. Conclusions: These results support the hypothesis that women suffering from PDD exhibit greater ischemic pain sensitivity compared with non-PDD controls. Several mechanisms may underlie this difference.