The Effect of Sublingual Testosterone on Ischemic Pain Sensitivity

Sex differences in pain have been reported for over a half-century with males having higher pain tolerance and lower pain sensitivity than females. Testosterone, a male hormone, is associated with pain perception in humans. However, as of yet no study has directly manipulated a participants’ testosterone to test for causal relationship between testosterone and pain. A double-blind fully-crossed study was conducted using sublingual administration of 0.5 mg testosterone. Twenty female participants completed two 5-hour sessions over a 3-day period. Participants completed an ischemic pain task, behavioral tasks and self-report measures at baseline and at post-administration to explore the effects of testosterone intervention on self-perceived health, aggression, risk-taking, body self-esteem, self-perceived mate value, sexual attitudes, and disgust. Three multilevel models were conducted to test how the drug intervention influenced levels of testosterone, estradiol, and progesterone. Testosterone was significantly higher for females who received the drug intervention as compared to females who received the placebo (p \u3c 0.001). A significant interaction between time and intervention was also found for estradiol (p \u3c 0.001) and progesterone (p \u3c 0.001) meaning that both hormones were higher in females who received the testosterone intervention. Several one-way repeated measure analysis of variance (ANOVAs) were carried out to examine the remainder of the outcome variables. Female participants given testosterone reported higher self-perceived physical functioning (p = 0.04) and exhibited higher risk-taking behavior when performing the Balloon Analogue Risk Task BART (p = 0.03) than those who received the placebo. However, testosterone did not influence the following variables: self-reported aggression, risk-taking behaviors, body image self-esteem, sexual attitudes, mate value, and disgust behaviors (p \u3e 0.05). These findings suggest that a single sublingual administration of 0.5 mg testosterone is not powerful enough to alter pain perception in female participants but is sufficient to alter levels of other sex hormones along with risk-taking behavior and perceived physical functioning

Perspectives of primary care physicians on acceptance and barriers to COVID-19 vaccination

OBJECTIVES: The purpose of this study was to examine the perspectives of primary care physicians in Texas around vaccine acceptance and potential patient barriers to vaccination. National surveys have shown fluctuating levels of acceptance for COVID-19 vaccination, and primary care physicians could play a crucial role in increasing vaccine uptake. DESIGN: This study employed a cross-sectional anonymous survey design to collect data using an online questionnaire. Participants were asked about vaccination practices and policies at their practice site, perceptions of patient and community acceptance and confidence in responding to patient vaccine concerns. SETTING: From November 2020 to January 2021, family medicine physicians and paediatricians completed an online questionnaire on COVID-19 vaccination that was distributed by professional associations. PARTICIPANTS: The survey was completed by 573 practising physicians, the majority of whom identified as family medicine physicians (71.0%) or paediatricians (25.7%), who are currently active in professional associations in Texas. RESULTS: About three-fourths (74.0%) of participants reported that they would get the vaccine as soon as it became available. They estimated that slightly more than half (59.2%) of their patients would accept the vaccine, and 67.0% expected that the COVID-19 vaccine would be accepted in their local community. The majority of participants (87.8%) reported always, almost always or usually endorsing vaccines, including high levels of intention to recommend COVID-19 vaccination (81.5%). Participants felt most confident responding to patient concerns related to education about vaccine types, safety and necessity and reported least confidence in responding to personal or religious objections to COVID-19 vaccination. CONCLUSIONS: The majority of the physicians surveyed stated that they would receive the COVID-19 vaccination when it was available to them and were confident in their ability to respond to patient concerns. With additional education, support and shifting COVID-19 vaccinations into primary care settings, primary care physicians can use the trust they have built with their patients to address vaccine hesitancy and potentially increase acceptance and uptake

Experimenter Effects on Pain Reporting in Women Vary across the Menstrual Cycle

Background. Separate lines of research have shown that menstrual cycling and contextual factors such as the gender of research personnel influence experimental pain reporting. Objectives. This study examines how brief, procedural interactions with female and male experimenters can affect experimentally reported pain (cold pressor task, CPT) across the menstrual cycle. Methods. Based on the menstrual calendars 94 naturally cycling women and 38 women using hormonal contraceptives (Mage=19.83,  SD=3.09) were assigned to low and high fertility groups. This assignment was based on estimates of their probability of conception given their current cycle day. Experimenters (12 males, 7 females) engaged in minimal procedural interactions with participants before the CPT was performed in solitude. Results. Naturally cycling women in the high fertility group showed significantly higher pain tolerance (81 sec, d=.79) following interactions with a male but not a female experimenter. Differences were not found for women in the low fertility or contraceptive groups. Discussion. The findings illustrate that menstrual functioning moderates the effect that experimenter gender has on pain reporting in women. Conclusion. These findings have implications for standardizing pain measurement protocols and understanding how basic biopsychosocial mechanisms (e.g., person-perception systems) can modulate pain experiences

Fluctuating experimental pain sensitivities across the menstrual cycle are contingent on women's romantic relationship status.

We explored the social-signaling hypothesis that variability in exogenous pain sensitivities across the menstrual cycle is moderated by women's current romantic relationship status and hence the availability of a solicitous social partner for expressing pain behaviors in regular, isochronal ways. In two studies, we used the menstrual calendars of healthy women to provide a detailed approximation of the women's probability of conception based on their current cycle-day, along with relationship status, and cold pressor pain and ischemic pain sensitivities, respectively. In the first study (n = 135; 18-46 yrs., Mage = 23 yrs., 50% natural cycling), we found that naturally-cycling, pair-bonded women showed a positive correlation between the probability of conception and ischemic pain intensity (r = .45), associations not found for single women or hormonal contraceptive-users. A second study (n = 107; 19-29 yrs., Mage = 20 yrs., 56% natural cycling) showed a similar association between greater conception risk and higher cold-pressor pain intensity in naturally-cycling, pair-bonded women only (r = .63). The findings show that variability in exogenous pain sensitivities across different fertility phases of the menstrual cycle is contingent on basic elements of women's social environment and inversely correspond to variability in naturally occurring, perimenstrual symptoms. These findings have wide-ranging implications for: a) standardizing pain measurement protocols; b) understanding basic biopsychosocial pain-related processes; c) addressing clinical pain experiences in women; and d) understanding how pain influences, and is influenced by, social relationships

The bi-variate correlations between the probability of conception on a given calendar-day and IPT pain tolerance for naturally cycling pair-bonded and single women and women using contraceptives.

<p>Probability of conception was calculated using the Wilcox findings which provide a precise estimate of the risk of pregnancy relative to intercourse on a given cycle day (counting from onset of previous menses; <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0091993#pone.0091993-Wilcox1" target="_blank">[77]</a>).</p

The partial correlations between the probability of conception on a given calendar-day and CPT pain intensity rating for naturally cycling pair-bonded and single women and women using contraceptives.

<p>Probability of conception was calculated using the Wilcox findings which provide a precise estimate of the risk of pregnancy relative to intercourse on a given cycle day (counting from onset of previous menses; <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0091993#pone.0091993-Wilcox1" target="_blank">[77]</a>). Length of relationship was partialled out of the correlations in the pair-bonded women.</p

The bi-variate correlations between the probability of conception on a given calendar-day and IPT pain intensity rating for naturally cycling pair-bonded and single women and women using contraceptives.

<p>Probability of conception was calculated using the Wilcox findings which provide a precise estimate of the risk of pregnancy relative to intercourse on a given cycle day (counting from onset of previous menses; <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0091993#pone.0091993-Wilcox1" target="_blank">[77]</a>).</p