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Sex Hormones and Pain Control

Introduction

Severe pain has major effects on the endocrine system. As science progresses, the role that sex hormones play in pain control is being further examined. In addition, hormone abnormalities may result if the individual experiences chronic pain. These abnormalities serve as biomarkers for the presence of intense pain and the need to replace hormones to achieve pain control. Initially severe pain causes a hyperarousal of the hypothalamic-pituitary-adrenal (HPA) system which results in elevated serum hormone levels such as adrenocorticotropin, cortisol, and pregnenolone. If the pain does not resolve, the HPA system cannot maintain its normal hormone production and balance. Consequently, levels of some hormones may decline. Conversely, several hormones are so critical for pain control that a deficiency may further enhance the pain.1

Sex Hormones in Women

This chapter will begin by examining the major sex hormone in a woman’s body which is estrogen, produced mainly by the ovaries. Women have estrogen receptor sites throughout their system including the brain, muscles, bone, bladder, gut, uterus, ovaries, vagina, breasts, eyes, heart, lungs, and blood vessels, to name a few. Estrogen has 400 critical functions, some of which are the following:2-14 • [1]

  • • Helps maintain the elasticity of arteries
  • • Dilates small arteries
  • • Increases blood flow
  • • Inhibits platelet stickiness
  • • Decreases the accumulation of plaque on arteries
  • • Enhances magnesium uptake and utilization
  • • Maintains the amount of collagen in the skin
  • • Decreases blood pressure
  • • Decreases LDL and prevents its oxidation
  • • Helps maintain memory
  • • Increases reasoning and new ideas
  • • Helps with fine motor skills
  • • Increases the water content of skin and is responsible for its thickness and softness
  • • Enhances the production of nerve-growth factor
  • • Increases HDL by 10 to 15%
  • • Reduces the overall risk of heart disease by 40 to 50%
  • • Decreases lipoprotein(a)
  • • Acts as a natural calcium channel blocker to keep arteries open
  • • Enhances energy
  • • Improves mood
  • • Increases concentration
  • • Maintains bone density
  • • Helps prevent glaucoma
  • • Increases sexual interest
  • • Reduces homocysteine
  • • Decreases wrinkles
  • • Protects against macular degeneration
  • • Decreases the risk of colon cancer
  • • Helps prevent tooth loss
  • • Aids in the formation of neurotransmitters in the brain such as serotonin which decreases depression, irritability, anxiety, and pain sensitivity
  • • Increases glucose and oxygen transport to the neurons
  • • Maintains the blood-brain barrier
  • • Protects neurons
  • • Increases the production of choline acetyltransferase, which is needed for the production of acetylcholine, the main neurotransmitter of memory

Progesterone is another sex hormone synthesized by the ovaries that has many functions in a woman’s body, including the following:215-20

  • • Balances estrogen
  • • Has a positive effect on her sleeping pattern
  • • Helps build bone
  • • Helps prevent anxiety, irritability, and mood swings
  • • Helps bladder function
  • • Regulates the smooth muscle in the gut so that the body can break down food into nutrients that are absorbed to be used elsewhere in the body

Testosterone falls into a class of hormones called androgens which are commonly referred to as “male” hormones but which are present in women as well. Testosterone is made in the ovaries, and a small amount is also made in the adrenal glands. It has numerous functions, which include:21-26

  • • Decreases bone deterioration
  • • Decreases excess body fat
  • • Aids with pain control
  • • Elevates norepinephrine in the brain consequently having an antidepressant effect
  • • Helps maintain memory
  • • Increases muscle mass and strength
  • • Increases muscle tone
  • • Increases sense of emotional well-being, self-confidence, and motivation
  • • Increases sexual interest

It is paramount that women maintain hormonal balance of all of their steroid hormones throughout their lifetime to help maintain optimal function as well as to aid in pain control.

Sex Hormones in Males

Testosterone is the main sex hormone produced by the male. It is produced by the Leydig cells in the testes, and a small amount is also produced in the adrenal glands. Men have hormone receptors in several locations in their body. Testosterone has many functions, including the following:27-41

  • • Important for sexual interest
  • • Involved in the making of protein and muscle formation
  • • Helps manufacture bone
  • • Improves oxygen uptake throughout the body
  • • Helps control blood sugar
  • • Needed for normal sperm development
  • • Regulates acute HPA responses under dominance challenge
  • • Helps regulate cholesterol
  • • Helps maintain a powerful immune system
  • • Aids in mental concentration
  • • Improves mood
  • • Helps protect the brain against Alzheimer’s disease
  • • Regulates the population of thromboxane A2 receptors on megakaryocytes and platelets and consequently platelet aggregation
  • • Aids in pain control

Progesterone also has the following functions in a male’s body:42

  • • Influences spermiogenesis
  • • Sperm capacitation/acrosome reaction
  • • Testosterone biosynthesis in the Leydig cells
  • • Blocking of gonadotropin secretion
  • • Sleep improvement
  • • Regulates immune system
  • • Positive cardiovascular effects
  • • Regulates kidney function
  • • Affects adipose tissue
  • • Regulates behavior
  • • Affects the respiratory system

Androgens aromatize into estrogens via the enzyme aromatase. Estrogens, at low levels, are important for a male to help maintain memory and bone structure.43

  • [1] Stimulates the production of choline acetyltransferase, an enzyme which preventsAlzheimer’s disease • Increases metabolic rate • Improves insulin sensitivity • Regulates body temperature • Helps prevent muscle damage • Helps maintain muscle • Improves sleep • Reduces risk of cataracts
 
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