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Menopause symptoms increase likelihood for chronic pain
Midlife women with documented menopause symptoms are nearly twice as likely to be diagnosed with either chronic pain or chronic pain multimorbidity, independent of mental health status and other risk factors, according to findings published in Menopause.
“In addition to hormonal changes and aging, the factors that predict not only having menopause symptoms, but finding them particularly bothersome, include comorbid health conditions, health risk behaviors and negative mood symptoms, which are also shared risk factors for chronic pain,” Carolyn J. Gibson, PhD, MPH, of the San Francisco VA Medical Center, and colleagues wrote in the study background. “Therefore, within this critical period, women with a higher menopause symptom burden may be most vulnerable for chronic pain.”
In a cross-sectional study, Gibson and colleagues analyzed Veterans Affairs medical and pharmacy records from 200,901 women aged 45 to 64 years with at least one VA encounter during 2014 and/or 2015 (mean age, 54 years; 58% white; 41% with obesity). Researchers used logistic regression models to examine associations between menopause symptoms (defined by menopause symptom-related diagnoses on at least two encounters or hormone therapy use) and chronic pain outcomes.
Within the cohort, 26% of women had documented menopause symptoms, and 51% had chronic pain.
PTSD was the most common mental health diagnosis in the cohort (18%), followed by anxiety (15%) and a depressive disorder (13%). The presence of overweight or obesity and all mental health diagnoses were higher among women with chronic pain, according to researchers. Indicators of menopause symptoms were more prevalent in women with chronic pain (33%) and chronic pain multimorbidity (37%) vs. women without chronic pain (18%; P < .001).
In logistic regression analysis, women with documented evidence of menopause symptoms had higher odds of being diagnosed with chronic pain (OR = 1.89; 95% CI, 1.85-1.94) and chronic pain multimorbidity (OR = 1.86; 95% CI, 1.83-1.9). Results persisted after adjustment for age, race, BMI, mental health comorbidities and substance use disorder diagnoses.
“Understanding health factors related to chronic pain, and the health-related context in which they occur, is essential for providing adequate, effective and comprehensive care,” the researchers wrote. “In the current study, evidence of menopause symptoms in the medical record was strongly and independently associated with chronic pain, meriting assessment in the clinical setting.”
with interdisciplinary care providers. – by Regina Schaffer
Disclosure: One of the authors reports she has received research grants through the University of California, San Francisco, from Astellas and Pfizer.
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Gibson CJ, et al. Menopause. 2019;doi:10.1097/GME.0000000000001312.