Background & Aims

Puberty marks the onset of differences in sex hormones and pain-related dimorphism between males and females with the latter reporting higher pain sensitivity[1,2]. Data from animal and human adult studies suggests testosterone has antinociceptive effects[3,4]. There is a paucity of studies examining the relationship between testosterone and experimental pain sensitivity in healthy adolescent females.

Methods

Healthy adolescent females underwent a standardized psychophysical testing that included heat pain threshold (HPT), cold pain threshold (CPT), cold pain tolerance duration (CPTo) (8°C waterbath, max 120-sec) and pain ratings to heat stimulus (46°C, 30-sec) and cold stimulus (8°C waterbath, 60-sec). In addition, participants completed the Pubertal Developmental Scale[5] and provided a blood sample for the analysis of serum total testosterone levels using mass spectrometry. Correlations were run to assess the relationships between total testosterone and HPT, CPT, CPTo, HS, and CS. Additionally, regression models were run to explore these associations while controlling for pubertal status (early vs mid vs late), menstrual phase (premenarchal vs follicular vs luteal), and time of blood draw.

Results

Thirty-six healthy adolescent females (mean age 11.86±1.38, age range 9-15 years) participated in the study. No significant correlations were found between total testosterone levels and HPT (r=0.094, p=0.585), CPT (r = 0.030, p=0.861), CPTo (r=0.114, p=0.509), pain ratings to heat stimulus (r=0.033, p=0.862), and pain ratings to cold stimulus (r=0.085, p=0.623). Controlling for the pubertal status, menstrual phase and time of blood draw did not change the results.

Conclusions

Contrary to our hypothesis, higher testosterone levels were not associated with lower thermal pain sensitivity in healthy adolescent females. Pubertal maturation is a critical period involving significant changes in pain sensitivity and sex hormones levels including testosterone. It is possible that testosterone is related to pain sensitivity only in adolescents at late pubertal status compared to early pubertal status; however, testing the interactions between testosterone levels and pubertal statuses in this study was not possible due to the small sample.

References

1.Nahman-Averbuch, H., Li, R., Boerner, K.E., Lewis, C., Garwood, S., Palermo, T.M. and Jordan, A., 2023. Alterations in pain during adolescence and puberty. Trends in Neurosciences, 46(4), pp.307-317.
2.Osborne, N.R. and Davis, K.D., 2022. Sex and gender differences in pain. In International Review of Neurobiology (Vol. 164, pp. 277-307). Academic Press.
3.Javed, F., Ahmed, H.B., Zafar, M.S., Shaikh, M.S., Rossouw, P.E., Michelogiannakis, D. and Alstergren, P., 2022. “Testosterone decreases temporomandibular joint nociception”—A systematic review of studies on animal models. Archives of Oral Biology, 139, p.105430.
4.White, H.D. and Robinson, T.D., 2015. A novel use for testosterone to treat central sensitization of chronic pain in fibromyalgia patients. International Immunopharmacology, 27(2), pp.244-248.
5.Petersen AC, Crockett L, Richards M, Boxer A. A self-report measure of pubertal status: Reliability, validity, and initial norms. Journal of youth and adolescence 1988;17(2):117-133.

Presenting Author

Joel Brown

Poster Authors

Gourav Banerjee

PhD, MSc Pain Management, BPT

Washington University School of Medicine

Lead Author

Topics

  • Pain in Special Populations: Adolescents