Hormonal and Mental Health Influences on Musculoskeletal Pain and Mastalgia in Physically Active Women.

BACKGROUND

The inflammatory response mediates the primary pain pathway in animals assigned female at birth, whereas sex hormones are cited as the primary mediator of the pain pathway in animals assigned male at birth. It is unclear if these sex-based pain mediators are also present within humans in cases of musculoskeletal pain.

OBJECTIVES

This study investigates the association of self-reported pain in the neck, back, arms, and breasts in physically active, full-busted women with their hormonal levels, anthropometry measures, and indicators of overall mental health.

STUDY

DESIGN

Twenty (20) healthy, full-busted women who were assigned female at birth and performed regular physical activity were recruited to participate in this cross-sectional observational study.

SETTING

University-research center in Houston, TX, USA.

METHODS

Patients completed a series of surveys and questionnaires regarding their medical health history, physical activity, and history of pain-including neck, back, and arm pain as well as mastalgia. The patients also underwent anthropomorphic measurements and a blood draw.

RESULTS

Patients demonstrated significant musculoskeletal pain, anxiety, and depression (P < 0.005). Estradiol, progesterone, and glycated hemoglobin levels were significantly associated with self-reported musculoskeletal pain in the neck, back, and arms, as was mastalgia. Additional covariates, including anxiety, number of children borne, and trunk anthropometry, were found to clarify hormonal and metabolic contributions to the patients' pain presentation.

LIMITATIONS: Limitations of this initial project include the small sample size (n = 20) of physically active women without current metabolic health complications (glycated hemoglobin values of less than 5.7%).

CONCLUSIONS

These data indicate significant influences of hormonal levels and metabolic health on musculoskeletal pain and mastalgia perceived in physically active women. The data also suggest that several control covariates, including self-reported anxiety, should be considered to clarify potential mechanistic pathways in pain presentation in women who were assigned female at birth.