Clinical pain perception and hormone replacement therapy in postmenopausal women experiencing orofacial pain.

Objective: The purpose of this study was to examine the magnitude of the relation between a postmenopausal woman's hormonal replacement status and clinical pain report in a sample of women experiencing orofacial pain. Design: To accomplish this, pain ratings were collected during a routine chronic pain evaluation at an orofacial pain clinic from a sample of 87 postmenopausal women. Results: Results of ANCOVA (controlling for pain duration) demonstrated that postmenopausal women receiving hormone replacement therapy (HRT) reported higher levels of pain than postmenopausal women not taking HRT. Numeric pain rating scales revealed large effect sizes for worst pain report (0.62), moderate differences for average (0.48) and current (0.39) pain levels, and trivial differences for least pain (0.04). Effect sizes for the McGill Pain Questionnaire indicated somewhat smaller differences (0.35-0.24) between the two groups. Conclusions: This study is among the first to examine the relation between a woman's hormonal status and clinical pain perception and is the first to investigate the role of HRT in a postmenopausal woman's orofacial pain report in a clinical treatment setting. This area of inquiry is particularly salient given the high percentage of women who choose to initiate HRT either after hysterectomy or with the onset of menopause.