Sex hormones contribute to pain severity

Daily Fluctuations of Progesterone and Testosterone Are Associated With Fibromyalgia Pain Severity – The Journal of Pain – Apr 2018 – Free full-text article

Article Outline


  • Relationships between sex hormones and fibromyalgia were assessed daily.
  • Progesterone, as well as testosterone, were associated with lower self-reported pain.
  • Estradiol fluctuations were not correlated with self-reported pain.
  • Pain was particularly elevated when progesterone was low and cortisol was high.


The purpose of this longitudinal blood sampling study was to examine relationships between sex hormones and fibromyalgia pain.

Eight women meeting case definition criteria for fibromyalgia provided venous blood samples and reported their fibromyalgia pain severity over 25 consecutive days.

This is such an extremely small sample size that I can’t believe it was enough to run a study.

All women exhibited normal menstrual cycles and were not taking oral contraceptives.

Cortisol, and the sex hormones estradiol, progesterone, and testosterone, were assayed from serum.

A linear mixed model was used to determine if fluctuations of sex hormones were associated with changes in pain severity.

In the entire sample, day to day changes in progesterone (P = .002) as well as testosterone (P = .015) were significantly and inversely correlated with pain severity.

There was no relationship between estradiol and pain (P = .551) or cortisol and pain (P = .633).

Since cortisol is a stress hormone, I’m surprised there was no correlation with pain levels, since we always told that stress leads to increased pain.

These results suggest that progesterone and testosterone play a protective role in fibromyalgia pain severity.

Sex and other hormones may serve to increase as well as decrease fibromyalgia pain severity.


Sex hormones fluctuate normally in women with fibromyalgia, but may still contribute to pain severity.

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