Sex hormones and the nervous system

Douglas J Lanska MD FAAN MS MSPH (

Dr. Lanska of the University of Wisconsin School of Medicine and Public Health, the Medical College of Wisconsin, and IM Sechenov First Moscow State Medical University has no relevant financial relationships to disclose.

Originally released October 22, 2010; last updated May 3, 2020; expires May 3, 2023

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.


Estrogens, progestins, and androgens represent the 3 major classes of endogenous sex steroids. Prototypical hormones in each class are estradiol, progesterone, and testosterone, respectively. 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 changes associated with the menstrual cycle, pregnancy, menopause, and use of oral contraceptives. Besides their effects on reproduction, estrogens exert neuroprotective effects against development or progression of brain diseases. Thus, estrogens improve the negative aspects of aging and some age-associated diseases in affecting 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 of 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 various molecules, including cytokines, hormones, and neurotransmitters.


• Relationships between endogenous and exogenous sex hormones influence the development and progression of many neurologic conditions including 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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