Pain and Sex Hormones: A Review of Current Understanding
Many studies have demonstrated sex-specific differences in pain sensitivity and pain threshold, but the underlying mechanisms remain unknown. Gonadal hormones may influence nociceptive processing. In this review article, the authors present the data and identify the many functions of gonadal hormones on several chronic pain conditions including migraine, tension headache, fibromyalgia, temporomandibular syndrome, rheumatoid arthritis, and back pain. An attempt is made to draw conclusions. (See Maurer AJ, Lissounov A, Knezevic I, et al. Pain and sex hormones: a review of current understanding. Pain Manag. 2016;6(3):285-296. doi:10.2217/pmt-2015-0002.PMID:26983893.)
Hormones in Pain Modulation And Their Clinical Implications For Pain Control: A Critical Review
The authors present an overview of many studies in an attempt to determine whether the relationship between the perception of pain and hormones is causative and how these processes interrelate. They note that the relationship between pain perception and endocrine effects suggests that hormone assays might be used as biomarkers of chronic pain syndromes and could be developed as therapeutic agents. (See Chen X, Zhang J, Wang X. Hormones in pain modulation and their clinical implications for pain control: a critical review. Hormones (Athens). 2016;15(3):313-320. doi:10.14310/horm.2002.1696.)
Sex Differences in the Epidemiology, Clinical Features, and Pathophysiology Of Migraine
The authors note that migraine is 2 to 3 times more prevalent with longer duration, increased risk of recurrence, and greater disability in women than in men. Several comorbidities have been identified in both sexes including asthma, anxiety, depression, and other chronic pain conditions. Migraine associated with an aura is a risk factor for vascular disease in women, but because of a paucity of data, the same relationship has not been determined in men. The conclusions drawn are that migraine is underdiagnosed in men, causing suboptimal treatment and less participation of men in trials. (See Vetvik KG, MacGregor EA. Sex differences in the epidemiology, clinical features, and pathophysiology of migraine. Lancet Neurol. 2016; pii:S1474-4422(16)30293-9. doi:10.1016/S1474-4422(16)30293-9.)