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Current Pain and Headache Reports
Published in: Current Pain and Headache Reports 5/2010

01-10-2010

Sex Hormones and Pain: The Evidence From Functional Imaging

Published in: Current Pain and Headache Reports | Issue 5/2010

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Abstract

There is a substantial body of epidemiological and clinical evidence suggesting that the sex hormones, particularly estradiol and progesterone, play a role in pain. Behavioral studies have not been useful in understanding the relationship between sex hormones and pain perception, and certainly have not helped to elucidate the mechanisms by which such effects may be mediated. This review aims to address the additional insights functional imaging has given us into the role of sex hormones in pain. Functional imaging techniques and experimental designs are discussed before the literature investigating specific questions relating to hormones and pain is reviewed. Finally, we conclude by considering how results of studies imaging the influence of sex hormones in related areas such as emotion and cognition also may inform our understanding of this complex area.
Literature
1.
LeResche L, Mancl LA, Drangsholt MT, et al.: Relationship of pain and symptoms to pubertal development in adolescents. Pain 2005, 118:201–209.CrossRefPubMed
2.
3.
LeResche L: Epidemiologic perspectives on sex differences in pain. In Sex, Gender and Pain. Progress in Pain Research and Management, vol 17. Edited by Fillingim RB. Seattle: IASP Press; 2000:233–249.
4.
Lentz GM, Bavendam T, Stenchever MA, et al.: Hormonal manipulation in women with chronic, cyclic irritable bladder symptoms and pelvic pain. Am J Obstet Gynecol 2002, 186:1268–1271.CrossRefPubMed
5.
Martin V, Wernke S, Mandell K, et al.: Medical oophorectomy with and without estrogen add-back therapy in the prevention of migraine headache. Headache 2003, 43:309–321.CrossRefPubMed
6.
Mathias JR, Clench MH, Reeves-Darby VG, et al.: Effect of leuprolide acetate in patients with moderate to severe functional bowel disease. Double-blind, placebo-controlled study. Dig Dis Sci 1994, 39:1155–1162.CrossRefPubMed
7.
Sherman JJ, LeResche L: Does experimental pain response vary across the menstrual cycle? A methodological review. Am J Physiol Regul Integr Comp Physiol 2006, 291:R245–256.PubMed
8.
Le Mellédo JM, Baker G: Role of progesterone and other neuroactive steroids in anxiety disorders. Expert Rev Neurother 2004, 4:851–860.CrossRefPubMed
9.
Steiner M, Dunn E, Born L: Hormones and mood: from menarche to menopause and beyond. J Affect Disord 2003, 74:67–83.CrossRefPubMed
10.
• Johnson MH: Essential Reproduction, edn 6. Oxford: Blackwell Publishing; 2007. This textbook is an excellent introduction to reproductive physiology and endocrinology.
11.
12.
Roglio I, Bianchi R, Gotti S, et al.: Neuroprotective effects of dihydroprogesterone and progesterone in an experimental model of nerve crush injury. Neuroscience 2008, 155:673–685.CrossRefPubMed
13.
Puri V, Puri S, Svojanovsky SR, et al.: Effects of oestrogen on trigeminal ganglia in culture: implications for hormonal effects on migraine. Cephalalgia 2006, 26:33–42.CrossRefPubMed
14.
Schuurs AH, Verheul HA: Effects of gender and sex steroids on the immune response. J Steroid Biochem 1990, 35:157–172.CrossRefPubMed
15.
Storer TW, Woodhouse L, Magliano L, et al.: Changes in muscle mass, muscle strength, and power but not physical function are related to testosterone dose in healthy older men. J Am Geriatr Soc 2008, 56:1991–1999.CrossRefPubMed
16.
Traupe T, Stettler CD, Li H, et al.: Distinct roles of estrogen receptors alpha and beta mediating acute vasodilation of epicardial coronary arteries. Hypertension 2007, 49:1364–1370.CrossRefPubMed
17.
Asarian L, Geary N: Modulation of appetite by gonadal steroid hormones. Philos Trans R Soc Lond B Biol Sci 2006, 361:1251–1263.CrossRefPubMed
18.
Alliende ME: Mean versus individual hormonal profiles in the menstrual cycle. Fertil Steril 2002, 78:90–95.CrossRefPubMed
19.
Ferrer J, Mtnez-Guisasola J, Díaz F, et al.: Plasma levels of beta-endorphin during the menstrual cycle. Gynecol Endocrinol 1997, 11:75–82.CrossRefPubMed
20.
•• Craft RM: Modulation of pain by estrogens. Pain 2007, 132(Suppl 1):S3–S12. This review covers both animal and human studies investigating the influence of estrogens on pain.CrossRefPubMed
21.
• Aloisi AM, Bachiocco V, Costantino A, et al.: Cross-sex hormone administration changes pain in transsexual women and men. Pain 2007, 132(Suppl 1):S60–S67. This paper presents intriguing results from a study that would not be ethically possible to replicate in any other cohort.CrossRefPubMed
22.
•• Fillingim RB, King CD, Ribeiro-Dasilva MC, et al.: Sex, gender, and pain: a review of recent clinical and experimental findings. J Pain 2009, 10:447–485. This is a very detailed review of the experimental and clinical evidence supporting an effect of sex and gender on pain.CrossRefPubMed
23.
Cooke B, Hegstrom CD, Villeneuve LS, Breedlove SM: Sexual differentiation of the vertebrate brain: principles and mechanisms. Front Neuroendocrinol 1998, 19:323–362.CrossRefPubMed
24.
Cicero TJ, Nock B, O’Connor L, Meyer ER: Role of steroids in sex differences in morphine-induced analgesia: activational and organizational effects. J Pharmacol Exp Ther 2002, 300:695–701.CrossRefPubMed
25.
Jezzard P, Matthews PM, Smith SM: Functional MRI: an introduction to methods. New York: Oxford University Press; 2003.
26.
Apkarian AV, Krauss BR, Fredrickson BE, Szeverenyi NM: Imaging the pain of low back pain: functional magnetic resonance imaging in combination with monitoring subjective pain perception allows the study of clinical pain states. Neurosci Lett 2001, 299:57–60.CrossRefPubMed
27.
Owen DG, Clarke CF, Ganapathy S, et al.: Using perfusion MRI to measure the dynamic changes in neural activation associated with tonic muscular pain. Pain 2010, 148:375–386.CrossRefPubMed
28.
Apkarian AV, Bushnell MC, Treede RD, Zubieta JK: Human brain mechanisms of pain perception and regulation in health and disease. Eur J Pain 2005, 9:463–484.CrossRefPubMed
29.
Fields HL, Basbaum AI: Central nervous system mechanisms of pain modulation. In Wall and Melzack’s Textbook of Pain, edn 5. Edited by MacMahon SB, Koltzenburg M. London: Churchill Livingstone; 2005:125–142.
30.
31.
Ghazni NF, Cahill CM, Stroman PW: Tactile sensory and pain networks in the human spinal cord and brain stem mapped by means of functional MR imaging. AJNR Am J Neuroradiol 2010, 31:661–667.CrossRefPubMed
32.
Choi JC, Park SK, Kim YH, et al.: Different brain activation patterns to pain and pain-related unpleasantness during the menstrual cycle. Anesthesiology 2006, 105:120–127.CrossRefPubMed
33.
de Leeuw R, Albuquerque RJ, Andersen AH, Carlson CR: Influence of estrogen on brain activation during stimulation with painful heat. J Oral Maxillofac Surg 2006, 64:158–166.CrossRefPubMed
34.
Smith YR, Stohler CS, Nichols TE, et al.: Pronociceptive and antinociceptive effects of estradiol through endogenous opioid neurotransmission in women. J Neurosci 2006, 26:5777–5785.CrossRefPubMed
35.
Craft RM, Ulibarri C, Leitl MD, Sumner JE: Dose- and time-dependent estradiol modulation of morphine antinociception in adult female rats. Eur J Pain 2008, 12:472–479.CrossRefPubMed
36.
Smith YR, Zubieta JK, del Carmen MG, et al.: Brain opioid receptor measurements by positron emission tomography in normal cycling women: relationship to luteinizing hormone pulsatility and gonadal steroid hormones. J Clin Endocrin Metab 1998, 83:4498–4505.CrossRef
37.
Daniell HW: Opioid endocrinopathy in women consuming prescribed sustained-action opioids for control of nonmalignant pain. J Pain 2008, 9:28–36.CrossRefPubMed
38.
Epperson CN, Haga K, Mason GF, et al.: Cortical gamma-aminobutyric acid levels across the menstrual cycle in healthy women and those with premenstrual dysphoric disorder: a proton magnetic resonance spectroscopy study. Arch Gen Psychiatry 2002, 59:851–858.CrossRefPubMed
39.
Hagelberg N, Martikainen IK, Mansikka H, et al.: Dopamine D2 receptor binding in the human brain is associated with the response to painful stimulation and pain modulatory capacity. Pain 2002, 99:273–279.CrossRefPubMed
40.
Scott DJ, Heitzeg MM, Koeppe RA, et al.: Variations in the human pain stress experience mediated by ventral and dorsal basal ganglia dopamine activity. J Neurosci 2006, 26:10789–10795.CrossRefPubMed
41.
Epperson CN, Haga K, Mason GF, et al.: Cortical gamma-aminobutyric acid levels across the menstrual cycle in healthy women and those with premenstrual dysphoric disorder: a proton magnetic resonance spectroscopy study. Arch Gen Psychiatry 2002, 59:851–858.CrossRefPubMed
42.
Amin Z, Epperson CN, Constable RT, Canli T: Effects of estrogen variation on neural correlates of emotional response inhibition. Neuroimage 2006, 32:457–464.CrossRefPubMed
43.
van Wingen G, Mattern C, Verkes RJ, et al.: Testosterone reduces amygdala-orbitofrontal cortex coupling. Psychoneuroendocrinology 2010, 35:105–113.CrossRefPubMed
44.
van Wingen G, van Broekhoven F, Verkes RJ, et al.: How progesterone impairs memory for biologically salient stimuli in healthy young women. J Neuroscience 2007, 27:11416–11423.CrossRef
45.
van Wingen G, Mattern C, Verkes RJ, et al.: Testosterone biases automatic memory processes in women towards potential mates. Neuroimage 2008, 43:114–120.CrossRefPubMed
46.
Fernández G, Weis S, Stoffel-Wagner B, et al.: Menstrual cycle-dependent neural plasticity in the adult human brain is hormone, task, and region specific. J Neurosci 2003, 23:3790–3795.PubMed
47.
Smith YR, Love T, Persad CC, et al.: Impact of combined estradiol and norethindrone therapy on visuospatial working memory assessed by functional magnetic resonance imaging. J Clin Endocrinol Metab 2006, 91:4476–4481.CrossRefPubMed
48.
Persad CC, Zubieta JK, Love T, et al.: Enhanced neuroactivation during verbal memory processing in postmenopausal women receiving short-term hormone therapy. Fertil Steril 2009, 92:197–204.CrossRefPubMed
49.
Domes G, Lischke A, Berger C, et al.: Effects of intranasal oxytocin on emotional face processing in women. Psychoneuroendocrinology 2010, 35:83–93.CrossRefPubMed
50.
Metadata
Title
Sex Hormones and Pain: The Evidence From Functional Imaging
Publication date
01-10-2010
Published in
Current Pain and Headache Reports / Issue 5/2010
Print ISSN: 1531-3433
Electronic ISSN: 1534-3081
DOI
https://doi.org/10.1007/s11916-010-0139-1

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