Summary: Doctors have long used corticosteroids for pain management. Now they know other hormones can help too. These include HCG, oxytocin, progesterone, estradiol, and testosterone. Hormones calm neuroinflammation (swelling and irritation in the nerves and brain). They also help nerves heal. Doctors are also looking at over-the-counter neurosteroids like DHEA. Your body releases hormones to fight pain and stress. So researchers now think hormones may be a good way to treat pain. They go after the root cause.
Today’s approach to chronic pain is not helping people enough. Medical science is still missing something. Some researchers think the missing link is hormones. Your body makes many hormones that drive healing and natural defense. In recent years, researchers have found new ones, like neurosteroids (NS). Hormones are not painkillers or opioids. They help treat the root cause of pain.
In many cases, doctors offer only symptom relief. There is no plan for a full cure. That is far from good enough. Using hormones for pain is not new. Doctors have used some hormones for pain for a long time. For example, corticosteroid shots into the joints can cut pain and swelling for a long time. They are also fairly safe. A short course of corticosteroids also helps with nerve pain (neuralgia) and arthritis flares.
What are neurosteroids, and how do they treat pain?
Neurosteroids are made in the brain. They act on brain cells like neurons and glial cells (the brain’s support and immune cells). They have a built-in power to reduce pain. These compounds also calm neuroinflammation and help nerves regrow. Researchers have found many neurosteroids. These include pregnenolone (PREG), dehydroepiandrosterone (DHEA), estradiol, progesterone, and even testosterone.
Many animal studies show neurosteroids help in several ways. They quiet the brain’s overactive immune cells, or glial cells. They shield the brain from more damage. At the same time, they boost nerve regrowth. For example, rat studies show PREG and DHEA can help heal a damaged spinal cord. Today there are two types of neurosteroid therapy. The first is replacement therapy. The second uses these hormones at higher-than-natural (supraphysiological) levels.
For pain, there are prescription hormones and non-prescription hormones. Doctors may use prescription hormones like testosterone, progesterone, and estradiol. Or they may suggest hormones you can buy without a prescription, like DHEA and PREG.
Prescription hormones can be used for pain in many ways. But experts advise using them on and off to avoid side effects. Over-the-counter hormones like DHEA and PREG are fine for regular, long-term use.
What other hormones help with chronic pain?
Your body makes many hormones. Doctors are still learning how they help in pain management. Take human chorionic gonadotropin (HCG). It is a strong hormone that raises testosterone, progesterone, and estradiol levels. Studies show it can work well for pain.
Researchers are also finding new ways hormones can help. Doctors have long known that corticosteroids calm swelling, and so pain. Now they see that corticosteroids may also act on the brain. There, they help lower neuroinflammation. So they may play a special role in chronic pain. Corticosteroids like prednisone, triamcinolone, and hydrocortisone seem to work well against neuroinflammation.
Corticosteroids also seem to calm neuroinflammation at much lower doses. So using low doses on and off may ease chronic or even intractable (hard-to-treat) pain. Another surprise is oxytocin. Oxytocin is known to act on the brain and change mood and behavior. But new studies show it may also help with pain. It acts on certain brain centers and turns down pain. Your body releases oxytocin on its own during stress or pain.
Oxytocin is a strong pain reliever. It works on the same receptors as opioids. That also means it does not help people who use opioids for pain. To sum up, neuroinflammation is a major cause of chronic or intractable pain. Using hormones instead of painkillers or opioids now looks like a better approach. Many neurohormones are fairly safe for long-term use. And they can help treat the root cause of pain.
Frequently asked questions
Does progesterone help with pain?
Progesterone is one of the neurosteroids. These are hormones the brain makes on its own, with a built-in power to reduce pain. Along with testosterone and estradiol, it is a prescription hormone doctors may use for pain. Like the others, it works by calming neuroinflammation and helping nerves heal. It does more than mask symptoms.
What hormones are used for chronic pain?
Corticosteroids have long been used for pain and swelling, including joint shots. Newer options include HCG, oxytocin, progesterone, estradiol and testosterone. There are also non-prescription neurosteroids: DHEA and pregnenolone (PREG). HCG raises testosterone, progesterone and estradiol levels. Oxytocin acts on brain centers to turn down pain.
How do doctors limit the side effects of hormone therapy for pain?
Experts advise using prescription hormones like testosterone, progesterone and estradiol on and off, not nonstop. This helps avoid side effects. Over-the-counter neurosteroids like DHEA and PREG are seen as fine for regular, longer use. Corticosteroids seem to calm neuroinflammation at much lower doses. So low doses used on and off may ease chronic pain.
Can oxytocin relieve pain?
Yes. Oxytocin is best known for shaping mood and behavior. But newer studies show it can also reduce pain by acting on certain brain centers. Your body releases it during stress or pain. It is a strong pain reliever that works on the same receptors as opioids. That also means it does not help people already using opioids for pain.
Dr. Gurpreet Singh Padda, MD, MBA, MHP
