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Bridging the gap in decades of data: researchers study how ovarian hormones impact pain and addiction

Published: Oct. 20, 2021 at 11:43 PM MST
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TUCSON, Ariz. (KOLD News 13) - Researchers at the University of Arizona are studying why women experience pain and addiction differently than men. Clinical trials have historically favored males, despite females being at a higher risk for both.

Hormones could be central to new treatments and recovery methods.

“If you’re in pain, how can we actually make it better and not just alleviate it?” asked Dr. Tally Largent-Milnes, an assistant professor of pharmacology. “The other arm of my lab is, ‘How do we get drugs to where they need to be?’ When we put that into a bigger picture, we are looking at how pain, drugs of abuse and sex differences overlap.”

Dr. Largent-Milnes is helping to bridge the gap in decades of data.

“In 1993, the [National Institute of Health] mandated that in clinical trials females be included,” she said. “So, it’s relatively recent if you think about how long clinical trails have been going on. Females are now included, but results are very rarely reported as female-to-male. That can be a bit misleading because if there is an effect in the female population but not in males, [the overall results] might even out so nothing is significant.”

Dr. Largent-Milnes is focusing on how ovarian hormones impact pain. Complimenting her work in family and community medicine is Dr. Alicia Allen. The assistant professor researching the impact of hormones on addiction.

“Until the early 2000s, much of the research done in the addiction realm was done primarily in males because [scientist] thought that women were too messy hormonal-wise,” Dr. Allen said.

Yet women are more susceptible to drug dependence.

“Men are more likely to have substance use disorders, but at every point of exposure, the woman is more likely to advance on that course,” said Dr. Allen. “Say an adolescent boy and an adolescent girl both smoked a cigarette, that adolescent girl is more likely to become dependent. Then if we follow them later on in life, the man is more likely to be able to successfully quit. Even if the woman quits, too, she is more likely to relapse.”

It’s the same for pain. Women are at a higher risk for developing certain chronic disorders.

“Fibromyalgia and migraine and inflammatory bowel disease,” Dr. Largent-Milnes said.

Migraines can be debilitating. On a pain scale of 0 to 10, a patient survey listed broken bones at 7, a typical migraine at 7.1, childbirth at 7.3, kidney stones at 8.3 and the worst migraine ever at 8.6.

Dr. Largent-Milnes says girls have the same chance of getting a migraine as boys until they hit puberty. Then, their chances triple compared to men. It drops back down to equal likelihood during menopause.

“There’s something about the ovarian hormones in puberty that is kicking the susceptibility into overdrive,” Dr. Largent-Milnes said.

According to Dr. Largent-Milnes, migraines fluctuate with menstrual cycles.

“Headaches tend to get worse when estrogen drops,” she said. “It’s really interesting because when you look at a pregnant population, a third of people who have pre-existing migraines get better, a third stay the same and a third get worse. What’s really interesting is in the transgender community, a female-to-male transition with pre-existing migraines tends to get better, while a male-to-female transition tends to get worse.”

“If a woman saw someone smoking when her progesterone levels were high, she may crave less than if her progesterone levels were low,” Dr. Allen said.

For women who misuse opioids, Dr. Allen says relapse rates are very high (at about 80%) after childbirth, making it the best time to intervene.

Dr. Allen hopes her work will pave the way for hormonal-based treatment. Dr. Largent-Milnes wants to get to the root cause of different pain in women.

“You can’t see counterfeit until you know the real thing,” said Dr. Largent-Milnes. “The importance is understanding how cyclicity is playing a role in these different pain states to better treat the population.”

The University of Arizona is looking for women of reproductive age to participate in various studies on hormones. Dr. Allen says they are looking for both women who are pregnant and those who aren’t, women who struggle with substance abuse and those who don’t. Any personal information gathered will be kept confidential. To sign up, click HERE.

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