The role of sex and stress hormones in adolescent pain across pubertal stages: A longitudinal analysis.

Pain is felt and expressed through a complex interaction of biological, psychological, and social factors. While hormonal factors have been linked with pain in humans, these factors are underexplored. In this study, daily-diary data from the publicly available Texas Longitudinal Study of Adolescent Stress Resilience and Health dataset was used to examine the longitudinal relationship between a series of stress and sex hormones with self-reported headache, backache, stomachache. Latent growth modeling within a generalized structural equation modelling framework was used. A total of 735 students from 9th grade high school contributed self-reported daily diary on their mental and physical health alongside saliva samples up to 10 days. Analyses included available diary observations with complete data for each model with analytic sample size ranging from 440 to 530 participants. The hormones cortisol, testosterone, estradiol, progesterone, and DHEA-S were all examined as independent variables. In the adjusted models that did not control for sex, higher testosterone was associated with a decrease in the likelihood of having backache (β = -.24, p < .001), headaches β = -.20, p < .001) and stomachache (β = -.19, p < .001). Cortisol was positively associated with a higher likelihood of backache (β =.16, p = .034). In a stratified analysis based on pubertal status, testosterone remained negatively associated with the likelihood of having a headache, backache, and stomachache for participants in late/post puberty. The current study provides evidence that variations in hormonal levels depend on pubertal status when impacting pain.