Patient Primer: Hormone Therapy for Chronic Pain

From testosterone to melatonin, hormone therapy can help to relieve certain types of chronic pain.

Hormones are essential to your body, and there is some research that they can prove useful in treating some chronic pain conditions.

Hormones are chemicals produced by your endocrine glands, and they work like messengers, sending signals to the rest of your body to keep it functioning properly. As a quick example, hormones control your metabolism – that is, how your body changes nutrients into energy.

Hormone Therapy for Osteoarthritis

A study published in the journal Arthritis and Rheumatism looked at how sex hormones (estrogen and testosterone) can help people with osteoarthritis.1 The researchers found that concentrations of these hormones can provide some pain relief to those with late-stage osteoarthritis.

Here’s how the study worked: the researchers wanted to look at chondrogenic progenitor cells (CPCs).  These cells are in tissue that’s affected by osteoarthritis, and they can help the tissue regenerate itself – if they’re activated by sex hormones.

Sex hormones aren’t just important for sex drive; estrogen and testosterone also help with cell growth and maintenance of muscles and bones, for example.  Therefore, the researchers wanted to see if sex hormones could make CPCs regenerate joint tissue.

The researchers examined tissue samples from 372 total knee replacement patients, and they found estrogen receptors and testosterone receptors in that tissue.  Putting estrogen or testosterone into the tissue cell did increase the regenerative properties of the CPCs—but that was sex-dependent.  Tissue from women was most influenced by estrogen; tissue from men was most influenced by testosterone.

The lead author of the study concluded, “Hormone replacement therapy in joint fluid may help mitigate the effects of OA and further investigation is needed.”

Testosterone Replacement for Chronic Pain Patients – Men and Women

First to clear up a misconception:  everyone, women included, has testosterone. Men just happen to have more of it.

Testosterone is important to pain control because it’s very involved in the body’s natural opioid activity.  Your body produces natural opioids—called endogenous opioids—such as endorphins, that are important for pain control. Testosterone helps keep the opioid receptors working well.

Therefore, if you have low testosterone levels, you may feel more pain.

If your doctor determines you have a testosterone deficiency, he or she may recommend a testosterone replacement.  There are several products available, so your doctor will make the best recommendation based on your case.

Other Types of Hormone Therapy

Melatonin is a hormone that naturally occurs in the body. It is very important in getting a healthy amount of sleep and typically is used by people suffering from insomnia, jet lag, or working night shifts. Lack of sleep can influence pain control negatively, especially people suffering from arthritis, fibromyalgia, irritable bowel syndrome, or some other type of chronic pain. Using melatonin is fairly common in the US with about 3.1 million adults using it.

Learn more about how hormones work on Practical Pain Management’s sister site EndocrineWeb.

Updated on: 06/23/20
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