性別差異對於疼痛感覺之影響

The Effects of Gonadal Hormones on Pain Responses

臨床很多疾病的發生和性別都有相關性，在疼痛這一方面，也有許多研究認為二者間有顯著關聯。雖然性腺荷爾蒙之主要功能是為了生殖，然而身體無一部分、無一細胞不受其影響。女性荷爾蒙可經由週邊組織釋放血管活性物質如prostacyclin，NO，造成血管擴張及痙攣反應而加強疼痛﹔在脊椎這個層面，女性荷爾蒙可以活化類嗎啡止痛系統，而降低疼痛﹔在大腦，性爾蒙也會經由乙醯膽鹼的作用來影響情緒與疼痛認知；性荷爾蒙也可調控神經傳導物質如草胺或內源性之類嗎啡或血清促進素來影響疼痛的表現。性荷爾蒙調控疼痛的機制至今仍未被清楚的揭露，進一步的深入研究是值得進行的。

Gonadal hormones affect not only reproductive system but also virtually all cells in the body. For example estrogen promotes nociception via their effects on the peripheral vessels by releasing of vasoactive mediators, e.g, prostacyclin and NO,canses vasodilation, or spasmogenic response. In spinal cord, estrogen reduces pain through the activation of κ－opioid analgesic system. Nevertheless, gonadal hormones affect cognitive function and emotion through their actions on the cholinergic system in the brain. Gonadal hormones also play an active role in modulating the balance of endogenous opioids and monoamines such as norepinephrine-,acetylcholine- and serotomin-mediated actions. The exact mechanisms by which gonadal hormones influence pain perception are far from beging fully elucidated. Delving deeper into the sex differences in each body region would certainly disclose some secrets.