Post-Endodontic Pain According to Menstrual Cycle Phases

This study aimed to evaluate whether the phase of the menstrual cycle affects pain after root canal treatment. A total of 99 patients (72 females and 27 males) who needed root canal treatment in lower molar teeth were included. Female participants were grouped according to their menstrual cycle phase: menstrual, proliferative, and secretory. All patients received the same endodontic treatment procedure under local anesthesia. Postoperative pain intensity was recorded using a Visual Analog Scale (VAS) at 8 hours, 8-24 hours, 24-48 hours, and 48-72 hours after treatment. Analgesic (ibuprofen) use was also recorded. The results showed that women in the menstrual and secretory phases experienced higher pain levels than men, while pain levels in the proliferative phase were similar to those in men. The findings suggest that the menstrual cycle phase may influence short-term pain perception after root canal treatment.

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Key information

Conditions

Root Canal Treatment Facial Pain Neurologic Manifestations Pain Pain, Postoperative Pathologic Processes Pathological Conditions, Signs and Symptoms Postoperative Complications Signs and Symptoms Stomatognathic Diseases Tooth Diseases Toothache

Age range

18 year–50 year

Sex eligibility

All sexes

Study type

Observational

Primary location

Recep Tayyip Erdoğan Univercity

Rize, 53020, Turkey (Türkiye)

About this study

This prospective clinical study investigates the effect of menstrual cycle phase on postendodontic pain intensity in female patients compared to male patients. Ninety-nine participants requiring endodontic treatment for asymptomatic necrotic mandibular molars were enrolled in the study. Female participants were categorized into menstrual, proliferative, or secretory phases based on the first day of their last menstrual period. All treatments were standardized and performed under local anesthesia with rubber dam isolation, including root canal preparation using rotary files, irrigation with 2.5% sodium hypochlorite and 17% EDTA, and obturation with root canal sealer. Postoperative pain was self-assessed using a Visual Analog Scale (VAS) at multiple time points for up to 72 hours, and analgesic consumption was recorded. Data were analyzed with nonparametric tests to compare pain levels across cycle phases and in male participants. This study provides detailed information on potential hormonal influences on postoperative pain and may guide clinicians in planning endodontic treatments to maximize postoperative comfort in female patients.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

Age 18-50 years
Male or female patients requiring endodontic treatment of asymptomatic
Necrotic mandibular first or second molars
Female patients with regular menstrual cycles
Patients who have not taken analgesics in the last 3 days
Patients willing to provide written informed consent

Exclusion criteria

Smoking habit
Systemic diseases or use of systemic drugs
Parafunctional habits such as bruxism
Preoperative pain
Teeth requiring prosthetic restoration
Teeth with external or internal resorption
Immature teeth
Periodontal probing depth > 3 mm
Pregnant women
Women with irregular menstrual cycles
Patients who refuse to participate

Treatment and study plan

root canal treathment

Procedure

All participants underwent standard root canal treatment under local anesthesia and rubber dam isolation. Root canals were prepared using ProTaper Next rotary files, irrigated with 2.5% sodium hypochlorite and 17% EDTA, dried with paper points, and filled using a sealant and gutta-percha. The teeth were then restored coronally with composite resin. Postoperative pain and analgesic use were monitored for 72 hours to assess the influence of menstrual cycle phase on pain perception. This standardized procedure ensures consistency across participants and allows comparisons between menstrual phases and between male patients.

Primary outcomes

Post-Endodontic Pain Intensity

Time frame: Up to 72 hours post-treatment.

Measured using Visual Analog Scale (VAS) at 8 hours, 8-24 hours, 24-48 hours, and 48-72 hours after root canal treatment. Participants self-recorded the highest pain intensity at each time point.

Sponsors and collaborators

Lead sponsor

Ahter Sanal Cikman

Other

Registry information

Official study title

Influence of Menstrual Cycle Phases on Post-Endodontic Pain: A Comparative Clinical Study With Male Patients

Acronym: PEP-MC

Important dates

Study start: 2023
Primary completion: 2025
Study completion: 2025
First posted: Dec 18, 2025
Registry last updated: Dec 26, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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Completed