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Chronic pain is a beast of a disorder that often requires a multimodal treatment approach – and lately, there has been an increased interest in compounded hormone therapy to relieve some symptoms of pain; here’s why.
Doctors and scientists are constantly researching new methods to help patients get relief without suffering from dangerous medication side effects associated with narcotics.
While the search for a cure is far from over, new information sheds light on the potential benefits of:
- Neurosteroids
- Human chorionic gonadotropin
- Corticosteroids
- Oxytocin
- Nandrolone
These substances may significantly reduce symptoms associated with neuro-inflammatory diseases, like Multiple Sclerosis (MS) and Parkinson’s.
But why do these drugs work – and what does the evidence really say?
The Role of Hormones in Pain Regulation
In the human body, hormones play an important role in the perception and regulation of pain.
Neurosteroids like estrogen and progesterone, for example, can significantly increase or decrease pain levels during a woman’s monthly cycle, but this effect isn’t limited to menstruation or even to the female gender.
Progesterone also makes it harder or easier for the brain to uptake endorphins and opioid drugs depending on levels within the body.
Other hormones, like testosterone or (3α,5α)3-Hydroxypregnan-20-one, may directly influence speed of healing or even block inflammation.
Corticosteroids like dexamethasone and prednisone, on the other hand, have long been utilized for joint injections and topical medications. They suppress overactive immune reactions and signal the body to speed healing, all while reducing inflammation, redness, and pain perception.
Hormones and the Brain
Hyper-specialized neurosteroids actively cross the blood-brain barrier. These include:
- Pregnenolone (PREG)
- Dehydroepiandrosterone (DHEA)
- Allopregnanolone
- Estradiol
- Progesterone
- Testosterone
Once in the brain, they either activate or deactivate gamma aminobutyric acid (GABA) and N-methyl-D-aspartate (NMDA). There, they provide neuroprotective features while also boosting analgesia.
Unlike opiate drugs, there is a far lower concern about side effects.
Plus, compounding makes it much easier to control the hormone dose, seeking resolution of symptoms without adding on new problems.
The fact that there is so much evidence to prove the role of these substances in pain is spurring on discussions about their use in intractable pain. For patients who suffer on a daily basis, these hormones could be the answer.
About Hormone Therapy for Chronic Pain
Hormone therapy for pain isn’t necessarily a “new science,” but the information we have does make a compelling case for supplementation and/or blocking certain hormones to lower pain levels.
One 2014 study tested oxytocin (considered the “love hormone”), and human chorionic gonadotropin, on patients suffering from chronic pain. The study was admittedly small, and thus, probably points to a need for more research than anything, but what it found was compelling.
Patients who took a combination of oxytocin and chorionic gonadotropin at the same time needed 10 percent lower opioid doses to achieve relief than their placebo-taking counterparts. Many also self-reported a reduction in pain.
Study author Dr. Forest Tennant told the American Academy of Pain Medicine “The benefit that these patients mostly talk about is somewhat subjective but relates to what patients routinely call a ‘feeling of well-being’.”
What does this mean? He says patients told study representatives they felt more alive and more willing to live – no small feat given the high risk for suicide in chronic pain patients.
This tells us two things about hormone therapy:
- It may directly provide anaesthesia and pain relief
- It may enhance a feeling of well-being that makes it easier for patients to cope with pain
Enhancing Your Own Ability to Handle Pain
Traditionally, the standard approach to treating pain was to evaluate its impact on quality of life, medicate it using analgesics, and hope the patient didn’t become “out of it” to the point at which they could no longer function.
We now know that opiate drugs have a much higher risk for abuse, addiction, and even simple tolerance, than was originally estimated. Furthermore, they can also lead to other health problems like:
- Osteoporosis
- Fatigue
- Weight gain
- Oddly enough, increased sensitivity to pain
Now, researchers are starting to explore the expansion of hormone therapy and supplements as an alternative. Instead of working against your body to prevent it from sending out signals, these drugs aid your body in developing its own inherent ability to manage pain from the outside in.
Benefits of Neurosteroid Hormones
According to Practical Pain Management, neurosteroid hormones benefit the human body’s pain management measures in three distinct ways:
- By suppressing overactive glial cells:
These are responsible for causing the sensation of pain and the experience of inflammation. Normally, the body becomes less and less able to handle overactive glial cells over time. This may benefit patients with conditions like Fibromyalgia, who suffer from central sensitivity.
- By protecting glial cells and neurons:
This extends their cellular lifespan. In conditions like MS, this could be the difference between progressive demyelination and sending a disease into remission. More research is needed, but even simple neuroprotection matters. It may prevent glial cells from overactivating in the first place.
- They directly heal the CNS, spinal cord, and brain:
This healing is beneficial, especially after severe injuries like severed or damaged spinal cords. In fact, some neurosteroids, like PREG, human chorionic gonadotropin (HCG), are already used in patients who are recovering from injuries and/or strokes.
Most available research seems to support the role of cortisol, DHEA, estradiol, pregnenolone, progesterone, and testosterone in pain control specifically – as in these core components seem to directly influence all neurosteroid levels.
But what does that mean for you, the patient, and can compounding help?
How Hormone Replacement Might Help
The correlation between hormone levels, neurosteroids, and the body’s own ability to control pain or uptake painkillers, cannot be understated. In fact, it’s so important than many endocrinologists now believe sub-levels of the six core hormones may directly cause certain pain conditions, like fibromyalgia.
If you have struggled to find the right pain treatment, it may be worth it to have your pharmacy or care team test your levels of:
- Cortisol
- DHEA
- Estradiol
- Pregnenolone
- Progesterone
- Testosterone
Should any of the levels be below normal – even by a small amount – compounded bioidentical hormone therapy can help you rebalance your system.
But why would you choose compounded hormone therapy, versus, say, a pill like Estrace or a DHEA supplement you get at your local grocery store?
Compounded Hormone Therapy & Bioidenticals for Effective Treatment
One of the biggest concerns with hormone replacement therapy is tipping the scale too far in the other direction.
Too MUCH supplementation can balance, and then overload, the system with hormones, leading to pain for the opposite reason.
Compounded hormone therapy are especially helpful because the dose can be created specifically for the patient. Your pharmacist can alter the prescription by the micro-gram or even by the unit to get you only what you need to achieve relief.
Have questions about whether hormone therapy might help you achieve better pain relief? Reach out to your local compounding pharmacy today.
There’s so much potential benefit, especially if you haven’t had success in other areas.