Pressure Pain Threshold, Depression and Anxiety in Women with Primary Dysmenorrhea: A Prospective Cohort Study

Abstract

Background: Primary dysmenorrhea is one of the main chronic pain conditions in women and is often associated with various psychiatric disorders and some painful conditions. Women with dysmenorrhea report the presence of abdominal and lumbar allodynia at the end of the menstrual cycle, suggesting an association between menstrual pain and increased mechanical hypersensitivity in the abdominal and lumbar regions. Therefore, the general objective of this study was to measure pressure pain thresholds and depressive and anxiety symptoms in Mexican women with primary dysmenorrhea. Methods: This prospective cohort study used a cross-sectional design with female students; being older than 17 years of age, being available during menstruation, and having moderate-to-severe primary dysmenorrhea diagnosed by a physician were inclusion criteria. After providing informed consent, the women completed a questionnaire assessing demographic information, variations in menstrual patterns, and menstrual pain and its severity. Similarly, the Beck Depression Inventory and Anxiety Inventory were administered to the participants prior to obtaining pressure pain thresholds at specific abdominal and lumbar points. The data were entered into a computerized database. Exploratory analysis was performed via Student’s t test, Pearson’s chi-square test, or analysis of variance. Statistical significance was considered when p < 0.05. Results: A total of 69 women were included in the study. The mean ± standard deviation age of all participants was 20.9 ± 1.9 years. The main locations of menstrual pain were the lower abdomen (87.0%) and the lumbar region (10.1%). In terms of pain severity, 65.2% of the participants reported moderate pain, and 34.8% reported severe pain. With respect to the pain pressure threshold at the six evaluated points, the threshold in the abdominal region was significantly lower than the threshold in the lumbar region (p < 0.05). No relationship was found between the severity of dysmenorrhea pain and the level of depression or anxiety or with the pain pressure thresholds (p > 0.05). Conclusions: The severity of dysmenorrhea pain in the participating women was not associated with anxiolytic or depressive states. No significant relationship was found between the severity of dysmenorrhea and the sensitivity of the pressure pain threshold in the areas evaluated.