Serum hormone levels in women with chronic pain
<p><b>Title:</b> Serum Hormone Levels in Women with Chronic Pain, The Women In Pain Study, Oxford (WIPSOx).</p> <p><b>Introduction:</b> </p> Regular menstrual cycles in post-menarchal women reflect a healthy hypothalamic-pituitary-ovarian (HPO) a...
| Main Author: | |
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| Other Authors: | |
| Format: | Thesis |
| Language: | English |
| Published: |
2019
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| _version_ | 1797084608575045632 |
|---|---|
| author | Buck, L |
| author2 | Williams, S |
| author_facet | Williams, S Buck, L |
| author_sort | Buck, L |
| collection | OXFORD |
| description | <p><b>Title:</b> Serum Hormone Levels in Women with Chronic Pain, The Women In Pain Study, Oxford (WIPSOx).</p>
<p><b>Introduction:</b> </p>
Regular menstrual cycles in post-menarchal women reflect a healthy hypothalamic-pituitary-ovarian (HPO) axis. It is well known that psychological stress can disrupt this axis both acutely and chronically leading to cycle irregularity or a period of amenorrhoea. High levels of opiate use, both for chronic pain and recreationally, can lead to suppression of ovarian endocrine function, amenorrhoea or even premature ovarian insufficiency. However, it is not known whether chronic pain in itself is a sufficient stressor to disrupt HPO axis activity.
<p><b>Aim of Investigation</b></p>
<p>This observational study aimed to investigate the extent to which hormone production is altered in women with chronic pain and to explore whether clinical symptoms relate to this suppression. </p>
<p><b>Methods:</b></p>
<p>Local ethical approval was obtained (Oxford REC 15/SC/0077). </p>
<p>Pre-menopausal women (aged 18 – 50) with chronic (>6 months) pelvic or musculoskeletal pain were recruited by advertisement. At a single research visit, subjects completed a detailed questionnaire, were weighed and measured and blood was drawn. All samples were analysed to determine levels of estradiol, progesterone, testosterone, follicle stimulating hormone (FSH), cortisol, Vitamin D and sex hormone binding globulin (SHBG). </p>
<p>Questionnaire data collected included: menstrual data; number and regularity of periods in the previous 6 months; date of last menstrual period; length of cycle; measures of psychological distress: Beck Depression scale (BDI), State-Trait Anxiety Inventory Scale (STAI), measures of sleep disturbance and current and past stressful events.</p>
<p><b>Results:</b></p>
<p>Menstrual cycles: </p>
33% of the cohort described irregular or absent cycles in the last 6 months. Comparing women with regular cycles to those with irregular/absent cycles, there was no significant difference in age; duration of pain; severity of pain; state anxiety, or depression. There were also no significant differences in any of these variables when women with regular cycles were compared to those with amenorrhoea for the last six months. </p>
<p>Serum hormone levels: </p>
<p>Four women were clinically hypoestrogenic and eight women were hypoandrogenic. However, forty-eight of the women had estradiol levels in the lowest quartile of the normal range and forty-eight had testosterone levels in the lowest quartile. </p>
<p><b>Conclusions:</b> </p>
<p>This study found high rates of menstrual cycle disturbance in a cohort of women with chronic pain who were of reproductive age. In line with this, low levels of estradiol and testosterone were present in approximately half of the cohort. Such changes in serum hormone levels of women with chronic pain may have a significant impact on their morbidity and potentially mortality. Health consequences include reduced fertility; increased risk of cardiovascular disease and osteoporosis; psychological sequelae; and potentially an exacerbation of pain symptoms.</p> |
| first_indexed | 2024-03-07T01:57:27Z |
| format | Thesis |
| id | oxford-uuid:9c32f3f7-24a8-4b41-8557-9a5ece16df37 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T01:57:27Z |
| publishDate | 2019 |
| record_format | dspace |
| spelling | oxford-uuid:9c32f3f7-24a8-4b41-8557-9a5ece16df372022-03-27T00:34:24ZSerum hormone levels in women with chronic painThesishttp://purl.org/coar/resource_type/c_bdccuuid:9c32f3f7-24a8-4b41-8557-9a5ece16df37EnglishORA Deposit2019Buck, LWilliams, SVincent, K<p><b>Title:</b> Serum Hormone Levels in Women with Chronic Pain, The Women In Pain Study, Oxford (WIPSOx).</p> <p><b>Introduction:</b> </p> Regular menstrual cycles in post-menarchal women reflect a healthy hypothalamic-pituitary-ovarian (HPO) axis. It is well known that psychological stress can disrupt this axis both acutely and chronically leading to cycle irregularity or a period of amenorrhoea. High levels of opiate use, both for chronic pain and recreationally, can lead to suppression of ovarian endocrine function, amenorrhoea or even premature ovarian insufficiency. However, it is not known whether chronic pain in itself is a sufficient stressor to disrupt HPO axis activity. <p><b>Aim of Investigation</b></p> <p>This observational study aimed to investigate the extent to which hormone production is altered in women with chronic pain and to explore whether clinical symptoms relate to this suppression. </p> <p><b>Methods:</b></p> <p>Local ethical approval was obtained (Oxford REC 15/SC/0077). </p> <p>Pre-menopausal women (aged 18 – 50) with chronic (>6 months) pelvic or musculoskeletal pain were recruited by advertisement. At a single research visit, subjects completed a detailed questionnaire, were weighed and measured and blood was drawn. All samples were analysed to determine levels of estradiol, progesterone, testosterone, follicle stimulating hormone (FSH), cortisol, Vitamin D and sex hormone binding globulin (SHBG). </p> <p>Questionnaire data collected included: menstrual data; number and regularity of periods in the previous 6 months; date of last menstrual period; length of cycle; measures of psychological distress: Beck Depression scale (BDI), State-Trait Anxiety Inventory Scale (STAI), measures of sleep disturbance and current and past stressful events.</p> <p><b>Results:</b></p> <p>Menstrual cycles: </p> 33% of the cohort described irregular or absent cycles in the last 6 months. Comparing women with regular cycles to those with irregular/absent cycles, there was no significant difference in age; duration of pain; severity of pain; state anxiety, or depression. There were also no significant differences in any of these variables when women with regular cycles were compared to those with amenorrhoea for the last six months. </p> <p>Serum hormone levels: </p> <p>Four women were clinically hypoestrogenic and eight women were hypoandrogenic. However, forty-eight of the women had estradiol levels in the lowest quartile of the normal range and forty-eight had testosterone levels in the lowest quartile. </p> <p><b>Conclusions:</b> </p> <p>This study found high rates of menstrual cycle disturbance in a cohort of women with chronic pain who were of reproductive age. In line with this, low levels of estradiol and testosterone were present in approximately half of the cohort. Such changes in serum hormone levels of women with chronic pain may have a significant impact on their morbidity and potentially mortality. Health consequences include reduced fertility; increased risk of cardiovascular disease and osteoporosis; psychological sequelae; and potentially an exacerbation of pain symptoms.</p> |
| spellingShingle | Buck, L Serum hormone levels in women with chronic pain |
| title | Serum hormone levels in women with chronic pain |
| title_full | Serum hormone levels in women with chronic pain |
| title_fullStr | Serum hormone levels in women with chronic pain |
| title_full_unstemmed | Serum hormone levels in women with chronic pain |
| title_short | Serum hormone levels in women with chronic pain |
| title_sort | serum hormone levels in women with chronic pain |
| work_keys_str_mv | AT buckl serumhormonelevelsinwomenwithchronicpain |