Testosterone Replacement in Chronic Pain Patients

By Forest Tennant, MD, DrPH and Lisa Lichota, DO

Adequate testosterone serum levels are required in males and females not just for libido and sexual function but also for cellular growth, healing, maintenance of muscle mass and bone, and central nervous system maintenance of opioid receptors, blood- brain barrier, and dopamine-norepinephrine activity.

Testosterone deficiency in chronic pain patients has now been recognized by many observers.1-6 Due to its critical biologic functions in pain control, testosterone testing and replacement (TR) should now become a mandatory component in the treatment of chronic pain. This paper summarizes the physiologic actions of testosterone relative to pain management and lays out practical guidelines for testing and treatment that can easily be adapted to pain practice… (See link for article.  It is excellent and very needed information.  Please read about my personal experiences below.)



I’ve self injected testosterone for years and I’m a woman.  My husband also injects T.

Are we crazed body builders?  Hardly….

For me, it started as severe PMS that I had pretty much my entire adult life.  I had one good week out of the month and that’s an understatement.  Not only did I struggle with pain but I struggled mentally.  It was as if someone painted my world gray.  I also riveted on things that normally I should be able to drop.  Thankfully, I had a holistic doctor who specialized in pain management as well as breast cancer.  Little did I know – testosterone helps both.  He actually told me one day, “I have no studies to prove this, only 35 years of experience but if you give testosterone to women, their breast cancer dries up.”  After trying progesterone cream with little effect, he asked if I’d like to try T.  Within 20 minutes, I felt it.  I felt it mentally, as if I could see color for the first time in my life.  Physically I felt blood rushing into areas I thought were dead.  Yes, it helped sex drive, but it did so much more than that.

Recently, I lowered my dose as I appeared high on paper.  Within weeks I developed the old familiar ovarian pain and then lower back pain so severe I could hardly stand.  I called my hormone doctor to run it by him, wondering if the two could be related.  He said that yes, they could be related and to go back up on the dose I was previously.  I had a female physical to rule things out first.  I also shared my theory for the pain (lowering my T) with the physician’s assistant.  Our conversation was interesting.  She said I was blessed to have found doctors willing to treat me with testosterone as the results were clear. She also said I would not receive that type of help in her mainstream facility.  This isn’t the first conversation of this sort I’ve had with mainstream doctors who admit that their hands are completely tied to convention – in spite of results and science. I also tried to convince Physician’s For Women and the Wisconsin Fertility Clinic to adopt using various forms of testosterone for suffering women – to no avail.

Armed with the knowledge I was normal physically I went back to my regular dose.

Within ONE injection, both the ovarian and back pain were GONE.

I tell this story to demonstrate how hormones can help dramatically with pain.

My husband’s story is similar, albeit different. Before he was diagnosed with Lyme/MSIDS it was discovered that his testosterone level was nonexistent and he had severe joint pain.  He started injections as well but the pain, although diminished, was still there.  Eventually, he developed a whole battery of symptoms consistent with tick-borne illness and he was diagnosed with Lyme/MSIDS.  For him, T has helped his mood as well as pain.  At various times he’s gone off T for certain tests. Every single time, PAIN comes back with a vengeance and he becomes depressed.

So why do I bring this up?

I don’t think we are alone.  Due to environmental toxins and estrogens (xenoestrogens), many are estrogen dominant.  “The Textbook of Bio-Identical Hormones,” by Edward Lichten M.D. shows in detail how estrogen disorders are prevalent.  Did you know that testosterone is a treatment for diabetes in men?  I didn’t either until I read the book.  It does so many things.

According to this article,

Estrogen dominance has also been linked to allergies, autoimmune disorders, breast cancer, uterine cancer, infertility, ovarian cysts, and increased blood clotting, and is also associated with acceleration of the aging process.  Put simply, estrogen dominance is an elevated estradiol to progesterone radio.

But for me, the addition of progesterone wasn’t enough.

And to counter the argument that hormones aren’t “natural,” please understand hormones are made from cholesterol – all of which is within the body and is completely natural.  There are obviously synthetic forms of hormones used for specific purposes but bioidential hormones are as natural as you can get.  For a great read:  Essentially, we’ve been told cholesterol is the bad guy.  Nothing could be further from the truth.  We need cholesterol.  The article also points out that toxicity, mercury poisoning and fluoride toxicity all contribute to hormone disruption.  Mercury can interfere with the conversion of progesterone into cortisol.

Unfortunately, hormones, like cholesterol, have been mischaracterized by mainstream medicine and are currently classified as class 3 substances along with Vicodin and Ketamine.  A class 3 drug has, “accepted medical use in treatment in the United States. Abuse of the drug may lead to moderate or low physical dependence or high psychological dependence.”

To understand why Medicine hates hormones:

In a nutshell Medicine (and pharmacists I might add) hates hormones due to a study called the Womens Health Initiative (WHI) trial which had numerous design flaws.  Researchers concluded things that weren’t verified in the data and over time many statements were retracted, but this little detail didn’t make the evening news, and medical professionals still tout the study as if it’s settled science – much like the Klempner study is used to keep Lyme/MSIDS patients from further treatment for continuing symptoms.  Also, they used Premarin, a synthetic hormone.  They never looked at bioidentical hormones.


Since the WHI, there  have been hundreds if not thousands of research articles identifying bio-identical hormones as safe and effective.  However, in the medical community, the thought is “If Premarin is bad, then you have to assume that bio-identical estrogen is bad also”.  The statement is logical, but unfortunately it has not been proven in the literature; in fact just the opposite.  Bio-identical hormones have been shown over and over to not have the same deleterious effects that there synthetic counterparts have, and yet, doctors continue to assume that bio-identicalls and synthetics are the same.

I will also add that another very real reason steroids are frowned upon is that they are cheap and natural and would solve so many problems that it would affect Big Pharma.

And just to play devil’s advocate, I’ll stick up for synthetics for just a moment.

I know of a patient who has severe endometriosis.  Her pain was of a magnitude that made life unbearable.  She tried everything mainstream medicine had to offer and actually had memory loss after one injection of Lupron. Under the supervision of a MD she is currently taking two synthetic steroids for severe endometriosis.  The results are clear – her pain is GONE.  She is enjoying a normal life. The use of these two hormones (nandrolone and stanozolol) lowers the sex hormone binding globulin (SHBG), which stops the bleeding, and the pain.  As I write this, 10 million women worldwide are suffering lives not worth living due to the pain of endometriosis.  It is the number one reason for infertility.  But, doctors are so afraid of hormones they would rather watch women suffer than learn for themselves the effectiveness of this simple treatment.  The other key ingredient that stops the androgenic effects (voice lowering and acne) is spironolactone.  To learn more about this cutting edge treatment:

So once again we see that for a certain subset of patients, a synthetic version may be more helpful and it’s, “the dose that makes the poison.”

Our family was forced to find these answers and testosterone has made all the difference in the world to our current health.
 I hope this helps someone out there.


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