The Relationship between Fibromyalgia and Pressure Pain Threshold in Patients with Dyspareunia
Here in this study, the pressure pain threshold at tender and control points was lower in patients with dyspareunia than in the control group as in fibromyalgia. In this article, the pain sensitivity may not be solely confined to genital area in these patients; some central mechanisms may be involved in its etiology and there are diffuse interactions in pain modulation.
To evaluate the number of tender points, pressure pain threshold and presence of fibromyalgia among women with or without dyspareunia.
The present cross-sectional study included 40 patients with dyspareunia and 30 healthy controls.
The participants were asked if they had engaged in sexual intercourse during the previous four weeks, and dyspareunia was rated from 0 to 3 based on the Marinoff Dyspareunia Scale. A pressure algometer (dolorimeter) was used to measure the pressure pain threshold. Fibromyalgia was diagnosed based on the 1990 American College of Rheumatology criteria. The depression status of the participants was assessed using the Beck Depression Inventory.
No statistically significant difference was found with regard to age, body mass index, habits (alcohol use and smoking), educational status and occupational status between the two groups.
Total myalgic score, total control score and tender point mean pain threshold were significantly lower in the group with dyspareunia. The number of tender points was significantly higher in patients with dyspareunia. The mean Beck Depression Inventory score was 14.7 ±8.4 in the dyspareunia group compared with 11.2 ±7.1 in the control group. Five (12.5%) of the patients with dyspareunia were diagnosed with fibromyalgia, whereas no patients in the control group were diagnosed with fibromyalgia. There was no significant difference between the two groups with regard to the presence of fibromyalgia.
The finding of lower pressure pain thresholds and a higher number of tender points among patients with dyspareunia suggests that these patients may have increased generalized pain thresholds.
Additional studies involving a larger number of patients are required to investigate the presence of central mechanisms in the pathogenesis of dyspareunia.