Sex hormones and the nervous system

Jasvinder Chawla MD MBA (Dr. Chawla of Loyola University Medical Center and Chief of Neurology at Hines VA Hospital has no relevant financial relationships to disclose.)
Zachary N London MD, editor. (Dr. London of the University of Michigan has no relevant financial relationships to disclose.)
Originally released October 22, 2010; last updated February 10, 2017; expires February 10, 2020

This article includes discussion of sex hormones and the nervous system, sexual disorder/problems, and psychosexual dysfunction. The foregoing terms may include synonyms, similar disorders, variations in usage, and abbreviations.

Overview

Estrogens, progestins, and androgens represent the 3 major classes of endogenous sex steroids. The prototypical hormones in each class include 17beta-estradiol, progesterone, and testosterone. Estetrol is a natural estrogen with important antioxidative activity. It is very well-recognized that many neurologic conditions are triggered by hormonal imbalance associated with menstrual cycle, pregnancy, menopause, and use of oral contraceptives. Besides their effects on reproduction, estrogens exert neuroprotective effects for brain diseases. Thus, estrogens improve the negative aspects of aging and age-associated diseases in the nervous system, including hypertension. Advances in laboratory testing have increased the visibility of hormone-binding sites within the nervous system. A more thorough understanding of the sex hormone–related neural function and dysfunction may permit rational hormonal and antihormonal therapies for many of the conditions.

Key points

 

• Plasma sex hormones are secreted from ovaries, testes, and adrenal glands but may also be derived from enzyme-mediated conversions from prohormones in extraglandular tissues.

 

• Sex hormones influence a broad spectrum of normal and abnormal neurologic functions.

 

• The immune, endocrine, and nervous systems communicate with each other through a myriad of molecules, including cytokines, hormones, and neurotransmitters.

 

• Relationships between endogenous and exogenous sex hormones and many neurologic conditions, such as migraine, stroke, and certain movement disorders like chorea, are well established.

 

• The effects of sex steroids on neurologic function in health and disease constitute a rapidly developing area of basic and clinical neuroscience.

 

• Fluctuating sex hormone levels also influence the expression of certain neuropsychiatric states and neuroendocrine disorders.

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