Cross-sex hormone administration changes pain in transsexual women and men.
Chronic pain is gender-related, since there is a clear predominance of one sex with respect to the other in most pain syndromes. Gonadal hormones are known to affect the occurrence and incidence of pain. Transsexuals receive cross-sex hormones to develop and maintain somatic characteristics of the opposite sex: male to female transsexuals (MtF) are administered estrogens and anti-androgens, while female to male transsexuals (FtM) are administered androgens. Hence, these subjects represent a model to study the relationship between sex hormones and pain. Questionnaires dealing with sociodemographic data and pain (occurrence, frequency, duration, intensity, location and associated symptoms) were administered to both MtF and FtM transsexuals under hormone treatment for sex reassignment for at least 1 year. Forty-seven MtF and 26 FtM completed the questionnaires. Fourteen of the 47 MtF (29.8%) reported painful conditions, which in 11 subjects were not present before the beginning of hormone treatment. Pain consisted mainly of headaches and breast and musculoskeletal pain. Five subjects suffered from more than one pain condition. Sixteen of the 26 FtM (61.5%) reported pain. In 11 subjects, the pain was present before the beginning of hormone intake, and in 6 of them it improved after testosterone administration. These data suggest that marked changes in sex hormones affect the occurrence of pain in a high percentage of humans but not in all of them. Whether these effects are due to peripheral or central actions of sex steroids is unknown.
Aloisi
Anna Maria
AM
Department of Physiology, Neuroscience and Applied Physiology Section, University of Siena, Via A. Moro, 2, 53100 Siena, Italy Anaesthesia and Intensive Care Unit, S. Orsola Hospital, Bologna, Italy Obstetrics and Gynaecology Unit, S. Orsola Hospital, Interdepartmental Centre for Sexual Health, University of Bologna, and M.I.T., Bologna, Italy Anaesthesia and Intensive Care Unit, S. Agostino-Estense New Hospital, Modena, Italy.
Bachiocco
Valeria
V
Costantino
Antonietta
A
Stefani
Rita
R
Ceccarelli
Ilaria
I
Bertaccini
Alessandro
A
Meriggiola
Maria Cristina
MC
D000328:Adult; D001940:Breast / Q000187:drug effects / Q000503:physiopathology; D017373:Cyproterone Acetate / Q000009:adverse effects; D004958:Estradiol / Q000009:adverse effects; D005260:Female; D012739:Gonadal Steroid Hormones / Q000097:blood / Q000494:pharmacology* / Q000627:therapeutic use; D006261:Headache / Q000139:chemically induced / Q000503:physiopathology; D006801:Humans; D008297:Male; D009141:Musculoskeletal System / Q000187:drug effects / Q000503:physiopathology; D010146:Pain / Q000139:chemically induced* / Q000188:drug therapy* / Q000503:physiopathology; D010147:Pain Measurement / Q000187:drug effects; D017288:Pain Threshold / Q000187:drug effects* / Q000502:physiology / Q000523:psychology; D010148:Intractable Pain / Q000139:chemically induced / Q000188:drug therapy / Q000503:physiopathology; D012727:Sex Characteristics; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013739:Testosterone / Q000009:adverse effects; D014189:Transsexualism / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology*
D012739:Gonadal Steroid Hormones; D013739:Testosterone; D017373:Cyproterone Acetate; D004958:Estradiol