Based on the experimental cross-sex hormone models results and following the epidemiologic trend of other pathologies in both hormonal profiles, it is reasonable to hypothesize that transgender patients might also show a similar behavior for visceral pain. Other experimental models have evaluated an increase in pain thresholds following the administration of testosterone, noticing less responsiveness to nociceptive stimuli after the hormone administration 23,32. The opposite was also true in male rats undergoing estrogen therapy, showing an increased pain sensitivity .
If pain is severe or persists beyond a week, consult a healthcare provider to rule out complications like infection or improper hormone absorption. For those experiencing persistent or severe pain, consulting a healthcare provider to review injection technique or consider alternative sites can provide additional relief. Comparatively, immediate post-injection pain from T shots is generally milder than the delayed onset muscle soreness (DOMS) that some individuals experience 24–48 hours later. From an analytical perspective, the primary cause of immediate post-injection pain is the mechanical process of the needle piercing the skin and muscle tissue.
This can cause joint pain or make existing joint issues worse. On the other hand, very low estrogen levels—often caused when doctors use medications to block estrogen—can also cause joint discomfort. Fluid retention is more common with injectable forms of testosterone, which may cause sudden rises in hormone levels.
Some people who have arthritis also have pain in their toes, wrists, and fingers. Arthritis is known for joint pain, but it comes in different forms with varying causes. In addition to its role in the male reproductive system, testosterone also helps maintain bone health. Low T develops when testosterone levels decrease in the body. Hormonal imbalances may also contribute to joint pain.
In some studies, people who received a placebo (a non-active treatment) also reported joint pain. Another study found that about 3% to 6% of men using testosterone injections had joint pain as a side effect. Some of the men using testosterone therapy reported muscle or joint discomfort, but it was not a major issue across the study group. In a few studies, participants receiving testosterone injections or gels reported mild to moderate joint pain. Joint pain is a possible concern for some people taking testosterone therapy.
Literature has consistently shown differences in pain perception in biological males and females. In the same way, some authors found that chronic pain is an independent quality of life predictor in biological male and female patients as in transgender patients . Changes in pain perception and pain-related chronic conditions have been most frequently evaluated as part of the quality-of-life assessment. In addition, testosterone also has other effects on the anatomy and the normal functioning of the vaginal canal, which may make the organ more susceptible to pain sensitivity and discomfort during the procedure . However, recent studies in transgender patients also show an increased frequency of complications, including skin excess and ptosis, abrasions, infection, and pain . However, this protection is lost following an ovariectomy or upon reaching menopause, which then explains the elevated prevalence of musculoskeletal pain in females and specifically females after menopause .
Although some controversial results have been found, a literature review of published studies implies that estrogens have important effects regulating pain by acting on intracellular receptors, modifying gene expression and G-coupled proteins distributed along the central and peripheral nervous systems . It has been established that biological males and females perceive pain differently and that it may be partially explained by their distinct hormonal profiles since birth, which are only further magnified during puberty. Hone-affiliated medical practices are independently owned and operated by licensed physicians who provide services using the Hone telehealth platform. Nutrition is the foundation for healthy testosterone, but it has its limits.