According to a statistic on women’s health “about 8 in 10 people with IC/BPS (interstitial cystitis/bladder pain syndrome) are women, although more men might have IC/BPS than we think. Men who actually have IC/BPS may be diagnosed with conditions that have similar symptoms, such as some prostate conditions.” Dr. Tu discussed using a noninvasive method to test IC/BPS: a three-dimensional transabdominal sonograph to measure bladder sensory volumes in eligible women. The participants experiencing moderate to severe dysmenorrhea pain had increased bladder pain and urgency, however dysmenorrhea pain was unrelated to bladder capacity. His results from this sonographic method proved to be reliable and showed it is possible sufferers experience higher mechanosensitivity, which increase the pervasiveness of bladder pain syndromes.
Dr. Tu’s study was only conducted on women, but it may have been interesting to see results in men. According to an article How Men and Women Feel Pain Differently, in Time magazine, there has been constant debate and studies conducted on who experiences more pain: men or women. The answer lies in “what is hurting and how”. Dr. Andreas Sander-Kiesling, looked over records of more than ten thousand patients that underwent surgery over the course of two years. These patients were asked to rate their pain within 24 hours of their surgical procedures. Results showed “men were 27% more likely to report feeling more pain after major operations such as heart and shoulder surgery, while women were more likely to show higher pain readings after relatively minor or routine ones such as biopsies and even abortions”. These women also reported less pain after invasive surgeries. This is interesting considering Dr. Tu conducted this study using a non-invasive procedure. Overall in this men vs. women pain study, women were more likely to report pain than men.
A fun fact this article stated that could explain the higher pain tolerance some of these women experienced could be explained through their age. The average age was 58 (post menopause) meaning these women experienced drops in estrogen levels. Low estrogen increases pain sensitivity, so higher levels could account for a higher pain tolerance/decreased sensitivity.
The ages of the women conducted in Dr. Tu’s study could have had a profound effect on his results if he had a higher number of older women (only women of ages 18+ were tested). Older women with lower estrogen counts could have contribute to the higher mechanosensitivity and the increase in bladder pain syndromes.
Another factor that plays a role with pain is psychological, minor procedures such as abortions or biopsies seem more frightening to women (biopsies are often associated with cancer). This anxiety can make women feel as if they are experiencing more pain as well. It would be intriguing to see how women reacted when being studied by Dr. Tu. Since this was non invasive it is a possibility they thought nothing of it and the psychological aspect might not have played as big a role.
Ultimately the factor of hormones makes sense when Dr. Tu’s results are observed. During the menstrual cycle hormone levels oscillate. Prior to the week of menstruation women’s hormone levels begin from the bottom and slowly rise. A week before menstruation hormone levels plunge—which could explain PMS symptoms such as dysmenorrhea. Low estrogen levels account for the increased pain sensitivity so it is only logical that those with dysmenorrhea exhibit increase of bladder pain syndrome.
References:
Tu, F.F., Epstein, A.E., Pozolo, K.E., Sexton, L.D., Melnyk, A.I., & Hellman, K.M., (2013). A
Non-Invasive Bladder Sensory Test Supports a Role for Dysmenorrhea Increasing Bladder Noxious Mechanosensitivity. The Clinical Journal of Pain, 29, 883-890.
Park, A. (2014, June 3). How Men and Women Feel Pain Differently. Retrieved December 12, 2014, http://time.com/2811585/how-men-and-women-feel-pain-differently/
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