Investigating central sensitization in women with primary dysmenorrhea: A narrative review

BACKGROUND: Primary dysmenorrhea (PD) is a prevalent menstrual disorder characterized by painful uterine cramps without any underlying pelvic pathology. The pathophysiology of PD is linked to the release of prostaglandins during menstruation, leading to increased uterine contractility and pain. Central sensitization (CS), a neurobiological process characterized by an amplified response to pain signals in the central nervous system, plays a crucial role in the perception and experience of pain. MATERIALS AND METHODS: In conducting a systematic search and rigorous data screening process, a total of six articles were selected for inclusion in this review based on their alignment with the predefined criteria and relevance to the research topic. Electronic database searches (PubMed Advanced: 6, Cochrane Library: 5, BioMed Central: 8, Science Direct: 9) yielded 58 studies. After removing duplicates and excluding studies on fibromyalgia, animal models, secondary dysmenorrhea, whiplash injury, and cervical dilatation, six publications remained RESULTS: Based on the analysis of six selected articles, this review evaluates CS and its implications for primary dysmenorrhea, focusing on altered sensory perception to elucidate the pain mechanisms associated with PD by comparing pain level in women with PD. CONCLUSION: Emerging evidence suggests CS plays a significant role in some PD cases. Women with this condition may exhibit symptoms indicative of CS pain. There is growing support for using both pharmacological and nonpharmacological treatments targeting CS, though current studies on their efficacy are insufficient. Recognizing CS’s role in PD is expected to spur further research.