# Hormonal Influence ##### Untangling Pain --- ![](https://youtu.be/V-J6MAAOOxY) --- ## tl;dr - Differences in pain experience often become more noticeable around puberty, suggesting hormones play a part. - Research on hormone treatment also points to a link, but it is not as simple as one hormone causing or fixing pain. - The menstrual cycle has a follicular phase and a luteal phase, divided by ovulation. - Progesterone is produced after ovulation, while oestrogen and testosterone also change through the cycle. - We all have these hormones in different amounts, and those changing patterns can influence pain. > [!abstract]- Transcript > > So this first part that we're going to look at is hormonal influence. > > How then do we know that hormones play a role when it comes to pain? Now there were two main points that cropped up when I was looking into this. Firstly, sex differences in pain conditions are not present in children until puberty. > > So this suggests that sex hormones play an important role when it comes to pain. > > And it was found that puberty is associated with reduced sensitivity to negative stimuli in boys, but increased sensitivity in girls. So if we think back to our pain science training, this means that our fire alarms are more likely to be set off in girls after puberty whereas they're less likely to be set off in boys. And again, hormones play a part in this. > > The second part that lets us know that hormones play a part is research into sex reassignment, so this research in sex reassignment looks at hormones and pain. Studies have found that in male to female transsexuals, so meaning that when a male transitions to a female, they are obviously prescribed treatment with oestrogen. The researchers found that a third of the subjects developed chronic pain during their treatment with oestrogen. And I think that's crazy. > > Not only that, but when they looked at female to male subjects, so when females were transitioning to males, they looked at those who had chronic pain before the start of treatment and they found that more than half of them actually improved after starting testosterone treatment. > > We can see that obviously hormones play a part when it comes to pain. And you would think that looking at that last bit of research for sex reassignment that oestrogen causes pain and that testosterone improves it. But unfortunately it's not as straightforward as that as we'll see. > > Now before we get into this a little bit more, I want to just give you a brief overview of the phases of the menstrual cycle. So the menstrual cycle is a story of two halves. So you have the follicular phase. And you have the luteal phase, and these phases are divided by ovulation, so your period is not the main event in your menstrual cycle, ovulation is! > > You've got the follicular phase, where it starts on day one, the first day that you bleed. And that goes all the way to ovulation roughly around about day 14, 15, although it's not exact, but say, let's say that for this training. And then once you ovulate, you then move into the luteal phase. And that lasts until the first day of your period again. > > Roughly you've got, let's say for training purposes, it's split in half, they're roughly 14, 15 days long each. So again, the first half is the follicular phase, the second half is the luteal phase, and they are divided by ovulation. > > Oestrogen dominates the first half of the follicular phase. The second half is where progesterone dominates. There is oestrogen there too, but progesterone tends to dominate more. > > Another thing you need to know is progesterone is only created after ovulation has occurred. > > So when we ovulate, an egg is released from the sac, and that little sac then becomes what's known as the corpus luteum. Corpus luteum as in luteal phase. And it's that corpus luteum that actually produces progesterone. So that means that if we do not ovulate, we do not release the egg, we do not have this little sac that becomes the corpus luteum, > > And we do not produce progesterone, so literally then it would just be oestrogen that dominates the whole cycle. > > We also have testosterone within our bodies. Even though it's thought that testosterone is a male hormone, predominantly it is, yes, but women have testosterone too. And this mainly peaks just before ovulation. > > Men and women, they all have oestrogen, they all have progesterone, and they all have testosterone, but they're in differing amounts. > > Men have way more testosterone than we do, and much less oestrogen and progesterone, and women have huge amounts of oestrogen and progesterone and little testosterone. > > If you are listening to this, I highly recommend that you check out the menstrual cycle chart, because it is well worth getting to know what that actually looks like and getting to know where these hormones actually change in your menstrual cycle. Next lesson → [[Untangling Pain – Module 3 Lesson 03 – Hormones & Pain|Hormones & Pain]] %% ## Extra ## ![[Meta/01 Attachments/PNIE Pain BLOG.assets/slide-9.jpeg|slide-9.jpeg]] ![[Meta/01 Attachments/PNIE Pain BLOG.assets/slide-10.jpeg|slide-10.jpeg]] ![[Meta/01 Attachments/PNIE Pain BLOG.assets/slide-11.jpeg|slide-11.jpeg]] --- ## Watch the lesson ## Version 1: Full Hormonal Influence How then do we know that hormones play a role when it comes to pain? There were two main points that cropped up when I was looking into this Sex Differences in Pain and Puberty Sex differences in pain conditions are not present in children until puberty This suggests that sex hormones play an important role when it comes to pain Puberty is associated with reduced sensitivity to negative stimuli in boys, but increased sensitivity in girls If we think back to our pain science training, this means that our fire alarms are more likely to be set off in girls after puberty whereas they’re less likely to be set off in boys Hormones play a part in this Hormones and Sex Reassignment Research Research into sex reassignment looks at hormones and pain Studies have found that in male to female transsexuals, so meaning that when a male transitions to a female, they are obviously prescribed treatment with oestrogen The researchers found that a third of the subjects developed chronic pain during their treatment with oestrogen I think that’s crazy When they looked at female to male subjects, so when females were transitioning to males, they looked at those who had chronic pain before the start of treatment They found that more than half of them actually improved after starting testosterone treatment We can see that obviously hormones play a part when it comes to pain You would think that looking at that last bit of research for sex reassignment that oestrogen causes pain and that testosterone improves it But unfortunately it’s not as straightforward as that as we’ll see Phases of the Menstrual Cycle I want to just give you a brief overview of the phases of the menstrual cycle The menstrual cycle is a story of two halves You have the follicular phase and you have the luteal phase These phases are divided by ovulation Your period is not the main event in your menstrual cycle, ovulation is Follicular and Luteal Phases You’ve got the follicular phase, where it starts on day one, the first day that you bleed That goes all the way to ovulation roughly around about day 14, 15, although it’s not exact, but let’s say that for this training Once you ovulate, you then move into the luteal phase That lasts until the first day of your period again Roughly, let’s say for training purposes, it’s split in half, they’re roughly 14, 15 days long each The first half is the follicular phase, the second half is the luteal phase, and they are divided by ovulation Hormonal Fluctuations in the Cycle Oestrogen dominates the first half of the follicular phase The second half is where progesterone dominates There is oestrogen there too, but progesterone tends to dominate more Progesterone is only created after ovulation has occurred Corpus Luteum and Progesterone When we ovulate, an egg is released from the sac, and that little sac then becomes what’s known as the corpus luteum Corpus luteum as in luteal phase It’s that corpus luteum that actually produces progesterone That means that if we do not ovulate, we do not release the egg, we do not have this little sac that becomes the corpus luteum And we do not produce progesterone So literally then it would just be oestrogen that dominates the whole cycle Testosterone in Women We also have testosterone within our bodies Even though it’s thought that testosterone is a male hormone, predominantly it is, yes, but women have testosterone too This mainly peaks just before ovulation Hormone Levels in Men vs. Women Men and women, they all have oestrogen, they all have progesterone, and they all have testosterone, but they’re in differing amounts Men have way more testosterone than we do, and much less oestrogen and progesterone Women have huge amounts of oestrogen and progesterone and little testosterone Menstrual Cycle Chart Recommendation If you are listening to this, I highly recommend that you check out the menstrual cycle chart It is well worth getting to know what that actually looks like and getting to know where these hormones actually change in your menstrual cycle ⸻ Resources or Mentioned Menstrual cycle chart ⸻ ⸻ Resources or Mentioned Menstrual cycle chart %%