Changes in hormones and experimental pain sensitivity in healthy girls: an exploratory longitudinal pilot study

Adolescence is a period of drastic biopsychosocial change that affects the trajectory of health into adulthood. Cross-sectional studies have reported that older youth typically exhibit lower experimental pain sensitivity than younger youth, but only one study thus far has directly examined this longitudinally. The factors contributing to changes in pain sensitivity remain unclear, but sex hormones, which dramatically fluctuate during adolescence, could play a key role.

This longitudinal study aimed to examine changes in experimental pain sensitivity/modulation and their relationship to changes in sex hormone levels.

Healthy girls (n = 35, 9-16 years old) completed quantitative sensory testing (QST) at baseline and 1-year follow-up including thermal/pressure pain threshold; heat/cold pain intensity; cold pain tolerance; mechanical temporal summation; offset analgesia; and heat/pressure conditioned pain modulation. Serum blood samples were analyzed for total testosterone, dihydrotestosterone (DHT), dehydroepiandrosterone (DHEA), DHEA-sulfate (DHEA-S), and androstenedione (A4). Pain measures that significantly differed from baseline to follow-up were dependent variables in bootstrapped linear regression models with sex hormones as individual predictors in separate models. Additional regressions included baseline age and changes in pubertal stage and menstrual phase as covariates.

Cold pain threshold (CPT) increased over 1 year (baseline = 11.93°C, follow-up = 15.72°C, P = 0.012). Increased ΔDHT predicted increased ΔCPT after controlling baseline age, Δpubertal stage, and Δmenstrual phase (ΔR ² = 0.294, ΔF _1,18 = 9.49, P = 0.006, β = 0.583), but no other relationships between ΔQST measures and Δsex hormones were significant.

These findings suggest that during puberty, changes in sex hormone levels may have minor contributions to changes in experimental pain sensitivity in healthy girls.