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Low Serum Oxytocin Concentrations Are Associated with Painful Menstruation

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Abstract

Oxytocin-dependent mechanisms are hypothesized to contribute to painful menses, but clinical trials of oxytocin antagonists for dysmenorrhea have had divergent outcomes. In contrast, broader studies have shown that increased systemic oxytocin concentrations are associated with increased pain tolerance and improved psychosocial function. We sought to confirm whether increased serum oxytocin concentrations are associated with menstrual pain and other psychosocial factors. Women with a history of primary dysmenorrhea (n = 19), secondary dysmenorrhea (n = 12), and healthy controls (n = 15) completed pain and psychosocial questionnaires, provided a medical history, and rated their pain during the first 48 h of menses. Serum samples were collected during menses to measure oxytocin concentrations. Oxytocin was significantly lower in participants with a history of primary (704 ± 33 pg/mL; p < 0.001) or secondary (711 ± 66 pg/mL; p < 0.01) dysmenorrhea compared to healthy controls (967 ± 53 pg/mL). Menstrual pain over the past 3 months (r = −0.58; p < 0.001) and during the study visit (r = −0.45; p = 0.002) was negatively correlated with oxytocin concentrations. Pain catastrophizing (r = −0.39), pain behavior (r = −0.32), and pain interference (r = −0.31) were also negatively correlated with oxytocin levels (p’s < 0.05). Oxytocin was not significantly correlated with psychosocial factors. Contrary to our hypothesis, women with a history of primary or secondary dysmenorrhea had lower oxytocin concentrations during menses when compared to healthy controls. Lower circulating oxytocin concentrations were also associated with worse menstrual pain and pain-related behavior. When considering the existing literature, low circulating oxytocin may be a sign of dysfunctional endogenous pain modulation.

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Acknowledgments

We would like to acknowledge Dr. Gerald Gebhart for his editorial advice. This work was funded by NICHD HD081709, HD091502, and NorthShore University HealthSystem.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, NorthShore University HealthSystem and The University of Chicago Pritzker School of Medicine, Evanston, IL, USA

    Folabomi A. Oladosu, Frank F. Tu & Kevin M. Hellman

  2. Marcella Niehoff School of Nursing, Loyola University, Chicago, IL, USA

    Lindsey B. Garfield

  3. Department of Obstetrics and Gynecology, NorthShore University HealthSystem, Evanston, IL, USA

    Ellen F. Garrison, Nicole D. Steiner & Genevieve E. Roth

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  1. Folabomi A. Oladosu
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  2. Frank F. Tu
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Correspondence to Kevin M. Hellman.

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F.F.T. is a consultant and speaker for AbbVie Pharmaceuticals. The remaining authors report no conflict of interest.

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Oladosu, F.A., Tu, F.F., Garfield, L.B. et al. Low Serum Oxytocin Concentrations Are Associated with Painful Menstruation. Reprod. Sci. 27, 668–674 (2020). https://doi.org/10.1007/s43032-019-00071-y

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