Question 1

What is the interplay between pain and emotion?

Laura Payne · Accepted Answer

The answer to this question is "it's complicated," but I will try to provide a general response that answers your question.  Our experience of pain is, in part, dependent on our emotions.  How we are feeling will affect how we experience pain at any given time.  Generally, if we're feeling more anxious, frustrated, or sad, we can experience pain more intensely.  And this is true for any kind of pain.  Of course, the reverse is also true in that pain (especially chronic pain) can lead us to feel sad, anxious, angry, or detached.  It becomes a vicious cycle that leads to both chronic pain and negative emotions.

Additionally, pain and emotion share similar neurobiological pathways in the central nervous system and the brain.  So, if one pathway is activated, it may be more likely to activate the other pathway as well.

The bottom line is that pain and emotions are inextricably linked, which is the case for every person and every type of pain.

Question 2

What is the likely hood of a parental relationship breakdown exacerbating menstrual pain in a young woman?

Laura Payne · Accepted Answer

I am not aware of any specific data linking parental relationship with menstrual pain.  In general, stress can impact pain and the menstrual cycle, but to my knowledge, specific types of stress have not been explored.

Question 3

Why is menstruation pain not considered being sick?

Laura Payne · Accepted Answer

This probably has to do with cultural and societal views about menstruation, but it does seem like this view is changing.  For example, China now permits women to take time off due to menstruation ("menstrual leave").   Hopefully this shift will happen in the US and other countries as well.

Question 4

Can chronic pain cause depression?

Laura Payne · Accepted Answer

We can't yet say that chronic pain causes depression (or vice versa), but we do know that they often go hand in hand.  There can be a few reasons for this.  First, the experience of chronic pain often leads us to start to withdraw from activities and limit what we do in our lives - for fear of experiencing more pain or not being able to participate in how we used to.  That withdrawal from important activities can certainly (and understandably) lead to feelings of depression.  Also, depression and pain do share common pathways in our nervous systems and brains.  So, if a pain pathway is activated, it could activate a depression pathway, too.  So, even though we can't identify the exact cause of pain or depression, they very often go together.

Question 5

How and why does pain transition from recurrent to chronic?

Laura Payne · Accepted Answer

This is a very important question, and it is perhaps what much of our pain research is focused on right now.  The short answer is, we don't know just yet.  However, we have some ideas.  One possibility is that when we experience recurrent pain over a long period of time, that regular activation of the pain pathways in our nervous systems and brains becomes "sensitized." That sensitization can lead to further experiences of pain.  It's also possible that a person may have pre-existing vulnerabilities that lead to first developing recurrent pain and then also later on developing chronic pain.  The other explanation is that it is some combination of both of these processes.

Question 6

What nutraceutical supplements would you recommend that I investigate to help with chronic period pain? I currently rely on advil and sometimes codeine to manage? Thank you

Laura Payne · Accepted Answer

I can't make any specific recommendations, in large part because the research has not clearly demonstrated the effectiveness of one type of nutraceutical supplement over another.  However, I would encourage you to do as much research on different products as you can to see if individual companies have any published data on their websites or some support for why their product would work.  Hopefully, more research on nutraceuticals will be available in the coming years.

Question 7

Can you recommend reading or resources to guide treatment approach and planning for a client with severe and complex endometriosis?

Laura Payne · Accepted Answer

I would highly recommend looking at the resources available through professional societies, such as the International Pelvic Pain Society, or advocacy groups such as the Endometriosis Foundation of America.  There are also some self-help books that may be of value, including "Endometriosis: the experts’ guide to treat, manage and live well with your symptoms" (Horne & Pearson) and "Endometriosis and pelvic pain" (Evans & Bush).

Question 8

How much does stress impact the menstrual cycle and pain?

Laura Payne · Accepted Answer

Studies have consistently show that there is a relationship between stress and the menstrual cycle and pain, but to my knowledge, no studies has been able to look at whether stress actually causes changes in the menstrual cycle and pain.

Question 9

What advice can you give women for handling period related cramps and discomfort?

Laura Payne · Accepted Answer

I would encourage any woman to first see her doctor about different treatment options. Typically, non-steroidal anti-inflammatory drugs (ibuprofen, aspirin, etc.) work well for the majority of women. However, it is important to make sure a doctor approves this treatment and can discuss when and how much to take. A doctor may also want to explore other potential causes for menstrual pain (endometriosis, etc.).  If this approach does not provide relief, it may be worth exploring additional interventions, as well as coping strategies.  For women who do not experience relief from standard approaches, it's important to keep trying different approaches until one is successful.

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