Musculoskeletal Health in Pregnancy and Postpartum

pp 19-39

Hormonal Influence on the Neuromusculoskeletal System in Pregnancy

  • Maria E. ReeseAffiliated withSpine and Sports Medicine, Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine/Rehabilitation Institute of Chicago Email author 
  • , Ellen CaseyAffiliated withDepartment of Family, Community and Preventive Medicine, Sports Medicine Fellowship, College of Medicine, Drexel University

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One of the hallmarks of pregnancy is the dramatic change of the hormonal milieu. The primary role of shifting hormones is to maintain and support the growing fetus and to allow the pregnant mother to carry and deliver a full-term, healthy infant. However, many of these hormones also have the potential to impact the mother’s neuromusculoskeletal system. In this chapter, we will discuss the growing body of literature regarding the influence of sex and related hormones on the neuromusculoskeletal system. In addition to focusing on the obstetrics literature, we will also extrapolate from research on nonpregnant women as well as from research on animal models as appropriate. We begin the chapter with background information on each of the hormones that will be discussed. We chose to organize the chapter by hormone-sensitive tissues to provide a framework for the clinician treating peripartum and postpartum females. Lastly, figures and tables throughout the chapter help summarize and provide a ready visual reference for the busy clinician.


Pregnancy Estrogen Progesterone Relaxin Testosterone Bone Cartilage Ligament Myotendinous unit Nervous system