Why is running a marathon like giving birth? The possible role of oxytocin in the underestimation of the memory of pain induced by labor and intense exercise

Abstract

Pain can be overestimated, underestimated or reported accurately at recall. The way pain is remembered seems to depend on certain factors, including the type of pain or, in other words, its cause, the context, and the meaning it has for the person suffering from it. For instance, episodes of chronic pain, as well as pain related to surgery, are often overestimated at recall. Interestingly, research shows that pain induced by parturition or marathon running is often underestimated at recall despite the fact that both are not only physically grueling but also emotionally intense experiences. However, both processes can likewise be considered positive events, as opposed to most that involve pain. On the neurophysiological level, one of the similarities between giving birth and running a marathon is the particular involvement of the oxytocin system. Oxytocin is involved both in parturition and intense exercise, for various reasons. During labor, oxytocin mediates uterine contractions, while in the case of extensive running it might be involved in the maintenance of fluid balance. It also has well-documented analgesic properties and plays an important role in memory formation and recall. It has been suggested that oxytocin modulates the output of the central nucleus of the amygdala (CeA) during the fear recall. Moreover, it has been demonstrated that oxytocin can impair fear learning and influence the memory of both positive and negative emotionally salient stimuli. We propose that the reason for pain to be remembered in a more favorable light is the central action of oxytocin in the central nucleus of the amygdala, first and foremost during the encoding phase.