Sex Hormones, Stress, Mood, Gut Health and Medication in Pain

Female hormones offer less protection against pain than male hormones, and hormonal fluctuations affect acute and chronic pain. About 80 percent of autoimmune disease occurs in women, and sex hormones act on joints, tendons, nerves and the brain in osteoarthritis. Headaches and migraine are linked to metabolic and endocrine factors. Rolf uses Sapolsky's inverted U to show that moderate stress is helpful while chronic high cortisol is pro-inflammatory and linked to immune weakening, high blood pressure, nerve sensitization and digestive problems. Depression often goes unrecognized, and musculoskeletal pain predicts depression in Danish workers. Autonomic dysregulation can help maintain pain. Muscle, gut, fat and bone also act as hormonal organs. Diet and the gut microbiome are tied to low-grade inflammation, osteoarthritis and low back pain, with interest in probiotics and the finding that exercise itself acts like one. Antibiotics, NSAIDs and polypharmacy can harm the microbiome. A case of a fit 60-year-old with widespread pain after 30 years of statins shows how medication can drive symptoms. He closes with the links between exercise, dementia and cancer risk.