Kevin M. Hellman

INTRODUCTION: Non-steroidal anti-inflammatory drugs (NSAIDs) are considered a first-line treatment for dysmenorrhea (menstrual pain). However, as much as 20% of women fail to achieve sufficient pain relief from NSAIDs, although factors asso…

Dysmenorrhea is often linked to uterine inflammation, but the additional factors and pathways that contribute to its pathophysiology remain poorly understood. Given growing evidence linking endoplasmic reticulum (ER) stress to inflammation …

OBJECTIVES: This study aimed to identify menstrual pain trajectories over 2 years in young women with moderate-to-severe intensity, and determine baseline factors, including modifiable variables, that differentiate these trajectories. METH…

Dysmenorrhea is highly prevalent and undertreated, substantially impairing quality of life in reproductive-age individuals. Excessive uterine contractility is widely considered a key mechanistic contributor to menstrual pain. We conducted a…

BACKGROUND: Dyspareunia, defined as pain before, during or after intercourse, is a subset of female sexual dysfunction with overlapping gynecologic, urologic and psychosocial etiologies. AIM: This study aimed to evaluate the impact of mens…

OBJECTIVE: To examine how eicosanoid levels in menstrual effluent of adolescents within 3 years of menarche relate to the severity of menstrual pain. DESIGN: Prospective cohort study. SETTING: Community teaching hospital. POPULATION OR S…

Dysmenorrhea (period pain) affects over 40% of women and is a leading cause of missed school and workdays. However, the molecular mechanisms underlying this pain are not fully understood. We conducted a systematic review (Prospero registrat…

aDepartment of Ob/Gyn, Endeavor Health, Evanston, IL, United States bDepartment of Ob/Gyn, The University of Chicago Pritzker School of Medicine, Chicago, IL, United States

BACKGROUND: The mechanisms responsible for menstrual pain are poorly understood. However, dynamic, noninvasive pelvic imaging of menstrual pain sufferers could aid in identifying therapeutic targets and testing novel treatments. OBJECTIVE:…

Dysmenorrhea is characterized by high rates of transition to chronic pain. In a previous study using structural equation modeling, we demonstrated that several symptom domains associated with the emerging concept of nociplastic pain can be …

AbstractMultimodal hypersensitivity (MMH)-greater sensitivity across multiple sensory modalities (eg, light, sound, temperature, pressure)-is associated with the development of chronic pain. However, previous MMH studies are restricted give…

Excess pain after visceral provocation has been suggested as a marker for chronic pelvic pain risk in women. However, few noninvasive tests have been validated that could be performed readily on youth in early risk windows. Therefore, we ev…

Although elevated estradiol levels facilitate chronic pelvic pain in animal models, it remains to be determined whether sex steroid levels are altered in a cross-section of women with chronic pelvic pain (CPP) and those at-risk for developi…

AIM: Prior research has primarily focused on static pain assessment, largely ignoring the dynamic nature of pain over time. We used a novel assessment tool for characterizing pain duration, frequency, and amplitude in women with dysmenorrhe…

Women who develop bladder pain syndrome (BPS), irritable bowel syndrome, or dyspareunia frequently have an antecedent history of dysmenorrhea. Despite the high prevalence of menstrual pain, its role in chronic pelvic pain emergence remains …

OBJECTIVE: Incomplete pain relief after administration of nonsteroidal anti-inflammatory drugs (NSAIDs) is common, but it is unknown whether malabsorption or heightened metabolism contributes to NSAID resistance. To explain the etiology of …

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 oxytoc…

Menstrual pain, also known as dysmenorrhea, is a leading risk factor for bladder pain syndrome (BPS). A better understanding of the mechanisms that predispose dysmenorrheic women to BPS is needed to develop prophylactic strategies. Abnormal…

BACKGROUND: Dysmenorrhea is a pervasive pain condition that affects 20-50% of reproductive-aged women. Distension of a visceral organ, such as the uterus, could elicit a visceromotor reflex, resulting in involuntary skeletal muscle activity…

BACKGROUND: The lack of noninvasive methods to study dysmenorrhea has resulted in poor understanding of the mechanisms underlying pain, insufficient diagnostic tests, and limited treatment options. To address this knowledge gap, we have dev…

INTRODUCTION: Prior research has suggested that changes in the MR signal occur in the myometrial layer in women with dysmenorrhea. Since the mechanisms of dysmenorrhea are poorly understood, characterization of the relationship between MR s…

BACKGROUND: Dysmenorrhea is a common risk factor for chronic pain conditions including bladder pain syndrome. Few studies have formally evaluated asymptomatic bladder pain sensitivity in dysmenorrhea, and whether this largely reflects exces…

Although nonsteroidal antiinflammatory drugs can alleviate menstrual pain, about 18% of women with dysmenorrhea are unresponsive, leaving them and their physicians to pursue less well-studied strategies. The goal of this review is to provid…

OBJECTIVE: To compare bladder sensitivity between patients with pelvic pain and patients who were pain free, undergoing noninvasive, controlled bladder distension via diuresis. We also sought to measure potential mechanisms underlying bladd…