A recently published study in the 'Urolithiasis' journal explained that the menstrual cycle phase had no effect on pain perception during the extracorporeal shock wave lithotripsy (ESWL) session. Also, menopause women felt less pain than menstruating women during the session.

Ekrem Islamoglu et al. investigated the effect of the menstrual cycle and menopause on ESWL-related pain outcome. A total of 145 women were examined since March 2017. They underwent the first session of ESWL for renal or ureteral stones. The patients were divided into two groups- menstruating and menopause women. The number of days between the last day of menses and ESWL was calculated for menstruating women and were separated as in the follicular phase (1–14 days) or the luteal phase (15–30 days) of menstruation. To control these two female groups, 149 men of similar age were considered in the study.

The patients recorded the experienced pain on a ten-point visual analog scale (VAS) after the method. They used the pain questionnaire to rate the severity of pain as no, mild, tolerable, and intolerable. Mean age of male and female patients was 42 ± 13 years and 43 ± 15 years. Although the stone burden did not differ between the female and male groups (p = 0.459), VAS score was not statistically different between genders (p = 0.293). In the pain questionnaire, men described a higher rate of mild pain, whereas women described a higher rate of tolerable pain. The mean VAS score was notably lower for the menopaused women group than menstruating women, young and old men.

The subgroup analysis portrayed that menopaused women group had lower VAS score and better pain questionnaire result than menstruating women. No statistically significant difference between the follicular and luteal phase of the menstrual cycle concerning mean VAS score and pain questionnaire results were found. As compared to the young men group, the only significant difference was pain questionnaire results between women in the luteal phase. As per the multiple regression analysis, only menstruation was an independent factor for VAS score.

The multiple regression analysis revealed that only menstruation was an independent factor for VAS score. The reduction of ESWL-related pain in menopause was not concerned with pain in the control male group.