The Role of Sex Hormones in Pain-Related Conditions

Abstract

Millions of people are affected by pain-related conditions worldwide. Literature has consistently shown that each individual experiences and perceives pain in a unique manner due to biological, environmental, and cultural factors in which they have been raised. It has been established that biological males and females perceive pain differently and that it may be partially explained by their distinct hormonal profiles since birth, which are only further magnified during puberty. For biological males, high levels of testosterone have shown to increase their pain threshold; and for biological females, estrogen fluctuations have shown to increase pain intensity and perception. However, sex hormones have not been studied in the context of pain treatment or their impact on biochemical pathways involved in pain perception. For this purpose, the transgender community serves as a unique population to investigate the impact of hormone replacement therapy on molecular pathways involved in the perception of pain. The purpose of this review is to explore the biochemistry of hormone replacement in transgender patients who also have other pain-related conditions such as headaches, fibromyalgia, temporomandibular myalgia, and visceral pain.

The presence of a robot in a close relationship reduces the hormonal changes associated with pain in a laboratory setting

“…Estrogen receptors are expressed in several regions of the nervous system involved in nociception, including the spinal cord, thalamus, amygdala, and cerebral cortex. It can affect pain-related gene expression, intracellular signaling, neurotransmitter release, and opioid system activity 52,53 . Furthermore, it played a role in pain perception.…”

Construction of the chronic temporomandibular disorder patients: the association between neural and psychological pathways

“…[51][52][53] Stress triggers the release of norepinephrine and cortisol while simultaneously decreasing testosterone levels, potentially contributing to the higher prevalence of pain in females. 54,55 The impact of stress and its associated humoral response has the potential to induce changes in immune response, potentially affecting gut function. This cascade effect may contribute to sensitisation processes, ultimately predisposing individuals to chronic pain.…”

Cholinergic interneurons in the nucleus accumbens are a site of cellular convergence for corticotropin release factor and estrogen regulation

“…ERα is not expressed heavily in spiny projection neurons post-synaptically; rather its presence has been noted on astrocytes, ChIs and other GABAergic interneurons within the NAc -though sex dependent differences in expression profiles have not been assessed 51,52 . Given the known behavioral interaction of sex and sex steroid cycle with stress, feeding behaviors and pain sensitivity [7][8][9] , we speculated that one potential role of striatal ERα is to regulate the expression and function of other GPCRs such as CRF-R1s, especially in theses "gatekeepers" of striatal output: the ChIs. We therefore assessed sex-and sex-steroid dependent changes in ERα and CRF-R1 mRNA expression across regions of the striatum, both overall and at the level of ChIs using fluorescent in situ hybridization strategies.…”

“…As such, these peptides and hormones with their accompanying receptors present in the hypothalamus are also present in the cortico-striatal-mesolimbic pathway. Within the hypothalamus, it has been shown the sexual dimorphism and circulating sex hormones effect the function other hormonal systems associated with stress, feeding and pain to modulate homeostatic sensitivity and behavioral output [7][8][9] . Yet the precise way that these neuropeptides and hormones regulate this cortico-striatal-mesolimbic pathway and interact with each other is understudied.…”