Sex Hormone Fluctuations Regulate Pain Severity in Women with Fibromyalgia
The severity of fibromyalgia pain was found to be associated with daily fluctuations of progesterone and testosterone hormones, according to the results of a study published in The Journal of Pain.
Fibromyalgia is a disease characterized by diffuse chronic pain that can severely impact a person’s ability to perform daily life activities. The disease is more frequent in women, with a female to male incidence ratio of 7:1.
A previous study showed that the incidence of pediatric fibromyalgia is similar in both genders until the onset of puberty, after which the disease starts to be more frequent among girls than boys. This disparity raised suspicions of a link between sex hormones and chronic pain.
A research team at the University of Alabama at Birmingham conducted a daily evaluation of sex hormone levels for more than 25 consecutive days in eight women diagnosed with fibromyalgia. All women kept daily reports of pain severity.
Analysis of estradiol, progesterone, and testosterone levels revealed that all the women analyzed had hormone levels consistent with normal menstrual cycles.
Day-to-day changes in both pain and hormone levels revealed that lower levels of progesterone and testosterone were significantly associated with increased pain.
Additional analyses revealed that participants had more severe pain when testosterone was low but cortisol was high, suggesting that pain can be modulated by the interaction between these two hormones.
Overall, the results suggest that “progesterone and testosterone play a protective role in fibromyalgia pain severity,” the researchers wrote.
The team believes that medications that help regulate hormone levels may be a potential option to manage pain severity in these women.
The mechanism by which sex hormones can regulate pain sensation is not fully understood. Several hypotheses have been proposed: that sex hormones may have an impact on the way sensory impulses are transmitted to the central nervous system; that they may influence the inflammatory status of nerve cells; or that they may modulate the way the brain deals with pain messages.
Additional studies are needed to explain the role of sex hormones in fibromyalgia in men and in post-menopausal women. Also, a better understanding of the impact of sex hormones on other symptoms of the disease is still necessary.