Menstrual cramps even suckier than previously thought

In short, this suggests that menstrual cramps not only suck, they make other pains that happen to be around worse.

Brain morphological changes associated with cyclic menstrual pain: "Volume 150, Issue 3, Pages 462-468 (September 2010)

Cheng-Hao Tuab, David M. Niddambc, Hsiang-Tai Chaod, Li-Fen Chenbce, Yong-Sheng Chenf, Yu-Te Wubeg, Tzu-Chen Yehbe, Jiing-Feng Lirngh, Jen-Chuen HsiehabceCorresponding Author Informationemail addressemail address

Primary dysmenorrhea (PDM) is the most prevalent gynecological disorder for women in the reproductive age. PDM patients suffer from lower abdominal pain that starts with the onset of the menstrual flow. Prolonged nociceptive input to the central nervous system can induce functional and structural alterations throughout the nervous system. In PDM, a chronic viscero-nociceptive drive of cyclic nature, indications of central sensitization and altered brain metabolism suggest a substantial central reorganization. Previously, we hypothesized that disinhibition of orbitofrontal networks could be responsible for increased pain and negative affect in PDM. Here, we further tested this hypothesis....Abnormal decreases were found in regions involved in pain transmission, higher level sensory processing, and affect regulation while increases were found in regions involved in pain modulation and in regulation of endocrine function. Moreover, GM changes in regions involved in top-down pain modulation and in generation of negative affect were related to the severity of the experienced PDM pain. Our results demonstrate that abnormal GM volume changes are present in PDM patients even in the absence of pain. These changes may underpin a combination of impaired pain inhibition, increased pain facilitation and increased affect. Our findings highlight that longer lasting central changes may occur not only in sustained chronic pain conditions but also in cyclic occurring pain conditions."

Heat therapy for abdominal pain

Hot.

ScienceDaily (Jul. 5, 2006)The old wives’ tale that heat relieves abdominal pain, such as colic or menstrual pain, has been scientifically proven by a UCL (University
College London) scientist, who will present the findings today at the
Physiological Society’s annual conference hosted by UCL.

Dr Brian King, of the UCL Department of Physiology, led the research
that found the molecular basis for the long-standing theory that heat,
such as that from a hot-water bottle applied to the skin, provides
relief from internal pains, such as stomach aches, for up to an hour.
Dr King said: “The pain of colic, cystitis and period pain is caused
by a temporary reduction in blood flow to or over-distension of hollow
organs such as the bowel or uterus, causing local tissue damage and
activating pain receptors.

“The heat doesn’t just provide comfort and have a placebo effect –
it actually deactivates the pain at a molecular level in much the same
way as pharmaceutical painkillers work. We have discovered how this
molecular process works.”
If heat over 40 degrees Celsius is applied to the skin near to where
internal pain is felt, it switches on heat receptors located at the
site of injury. These heat receptors in turn block the effect of
chemical messengers that cause pain to be detected by the body.

The team found that the heat receptor, known as TRPV1, can block
P2X3 pain receptors. These pain receptors are activated by ATP, the
body’s source of energy, when it is released from damaged and dying
cells. By blocking the pain receptors, TRPV1 is able to stop the pain
being sensed by the body.

Dr King added: “The problem with heat is that it can only provide
temporary relief. The focus of future research will continue to be the
discovery and development of pain relief drugs that will block P2X3
pain receptors. Our research adds to a body of work showing that P2X3
receptors are key to the development of drugs that will alleviate
debilitating internal pain.”

Scientists made this discovery using recombinant DNA technology to
make both heat and pain receptor proteins in the same host cell and
watching the molecular interactions between the TRPV1 protein and the
P2X3 protein, switched on by capsaicin, the active ingredient in
chilli, and ATP, respectively.

Adapted from materials provided by University College London.
University College London (2006, July 5). Heat Halts Pain Inside The Body. ScienceDaily. Retrieved March 19, 2008, from http://www.sciencedaily.com­ /releases/2006/07/060705090603.htm

Heat and pain

Hot.

ScienceDaily (Jul. 5, 2006)

The old wives’ tale that heat relieves abdominal pain, such as colic or menstrual pain, has been scientifically proven by a UCL (University College London) scientist, who will present the findings today at the Physiological Society’s annual conference hosted by UCL.
Dr Brian King, of the UCL Department of Physiology, led the research that found the molecular basis for the long-standing theory that heat,such as that from a hot-water bottle applied to the skin, provides relief from internal pains, such as stomach aches, for up to an hour.

Dr King said: “The pain of colic, cystitis and period pain is caused by a temporary reduction in blood flow to or over-distension of hollow organs such as the bowel or uterus, causing local tissue damage and activating pain receptors.

“The heat doesn’t just provide comfort and have a placebo effect – it actually deactivates the pain at a molecular level in much the same way as pharmaceutical painkillers work. We have discovered how this molecular process works.”

If heat over 40 degrees Celsius is applied to the skin near to where internal pain is felt, it switches on heat receptors located at the site of injury. These heat receptors in turn block the effect of chemical messengers that cause pain to be detected by the body.

The team found that the heat receptor, known as TRPV1, can block P2X3 pain receptors. These pain receptors are activated by ATP, the body’s source of energy, when it is released from damaged and dying cells. By blocking the pain receptors, TRPV1 is able to stop the pain being sensed by the body.

(2006, July 5). Heat Halts Pain Inside The Body. ScienceDaily. Retrieved March 19, 2008, from http://www.sciencedaily.com­ /releases/2006/07/060705090603.htm

Being realistic about labor pain

Interesting.

ScienceDaily (Mar. 17, 2008) — A pain-free and drug-free labour may be many expectant mothers' dream but a review in the open access journal BMC Medicine reveals that reality hits hard. Most women's labour experiences differ markedly from their expectations. They are often ill-prepared for what might happen and consequently may be disappointed when the birth does not "go to plan".

The study's authors conclude that antenatal programmes should "get real". "People involved in antenatal care should listen to women's hopes for labour whilst also preparing them for what might actually happen during labour," said Joanne Lally of Newcastle University, who led the investigation. "Plans for a labour free of pain relief need to be complemented by preparing women for the possibility that they might need pain relief. Education can help to fill the gap between expectation and experience and thus ensure women are realistically prepared for their birthing experience."

The research team from Newcastle University studied published literature on women's expectations and experience of pain and pain relief in labour. They found that a gap exists between expectations and experience in four key areas: the level and type of pain, access to pain relief, the level of participation in and control over decision--making, and the level of control during labour.

Most of the literature reviewed showed that women underestimate the intensity of the pain they will experience and sometimes hold an unrealistic ideal for a drug-free labour. Indeed, in one study, more than half of the women interviewed who said they would not use pain relief actually did use it.

"Our analysis highlights the importance of antenatal education. It can empower women to have realistic expectations and make informed decisions," notes the author.

"If women can be better educated they can express their preferences but also be aware that things may not always go to plan. They can then be prepared for different eventualities and so make more realistic decisions and have a better experience."

Birth plans or other decision aids can assist women when making decisions about pain relief in labour, but evidence suggests these are not widely used. Recent guidelines published by the National Institute for Clinical Excellence (NICE) call for more research into how health professionals can effectively support pregnant women in making informed decisions about labour.

Journal reference: More in hope than expectation: Women's experience and expectations of pain relief in labour: A review. Joanne E Lally, Madeleine J Murtagh, Sheila Macphail and Richard G Thomson. BMC Medicine (in press)

Adapted from materials provided by BioMed Central, via EurekAlert!, a service of AAAS.

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Period pain

Fyi

Ibuprofen beats acetaminophen for period pain

NEW YORK (Reuters Health) - Although both ibuprofen and acetaminophen reduce menstrual pain, ibuprofen appears to have more potent effects, according to investigators from the West Virginia University School of Medicine, Morgantown.

Although ibuprofen is accepted as an effective treatment for painful periods, or dysmenorrhea, Drs. M. Yusoff Dawood and Firyal S. Khan-Dawood note in the American Journal of Obstetrics and Gynecology, there is still controversy about the usefulness of acetaminophen. Acetaminophen, the active ingredient in Tylenol, is known as paracetamol in several countries.

To investigate further, the duo conducted a small trial involving 12 women with dysmenorrhea who were given three different treatments in random order for three different periods: 1000 milligrams of acetaminophen, 400 milligrams of ibuprofen, or an inactive placebo, four times daily for three days.

The women rated the active medications as being more effective than placebo. "However," Dr. Dawood told Reuters Health, "it appears that ibuprofen has a greater effect and patients also preferred it."

SOURCE: American Journal of Obstetrics and Gynecology, January 2007

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