Premature surgical menopause tied to musculoskeletal discomfort, sarcopenia risk

Key takeaways:

• Women with premature surgical menopause reported more musculoskeletal discomfort and sarcopenia than those with normal age of menopause.
• Hormone therapy and physical activity reduced sarcopenia risk.

Premature surgical menopause may increase the likelihood of musculoskeletal discomfort and sarcopenia, highlighting the potential importance of hormones in postmenopausal musculoskeletal health, researchers reported in Menopause.

“Due to the progressive deterioration of muscle function and mass in the postmenopausal period, assessment of the muscle-estrogen relationship acquires special relevance,” Maria S. Vallejo, MD, from the obstetrics and gynecology service at the Clinical Hospital of the University of Chile, and colleagues wrote. “Ovarian hormone levels decrease significantly in women who have experienced premature menopause, either spontaneous or surgical.”

Vallejo and colleagues conducted a cross-sectional, observational and multinational study with data from 644 postmenopausal women (mean age, 60.9 years) aged 55 to 70 years from nine Latin American counties from January to November 2023. Of these women, 468 had normal age of menopause, 116 had spontaneous premature menopause and 60 had premature surgical menopause. All women completed a general questionnaire, question No. 4 in the Menopause Rating Scale assessing musculoskeletal discomfort and the SARC-F — strength, assistance with walking, rise from a chair, climb stairs, falls — questionnaire to assess sarcopenia.

Women with premature menopause had more musculoskeletal discomfort (33.5% vs. 20.9%; P < .001) and a higher likelihood of sarcopenia (35.2% vs. 19.9%; P < .001) compared with women with normal age of menopause. Those with premature surgical menopause had a higher prevalence of severe musculoskeletal discomfort (46.7% vs. 29.3%; P < .02) and a higher likelihood of sarcopenia (45% vs. 27.6%; P < .02) compared with women with premature spontaneous menopause.

When adjusted for covariates, premature spontaneous menopause was not associated with higher odds of musculoskeletal discomfort, and odds of sarcopenia were not significantly different compared with women with natural age of menopause. Conversely, women with premature surgical menopause had a higher likelihood of musculoskeletal discomforts (OR = 2.26; 95% CI, 1.22-4.17) and sarcopenia (OR = 2.05; 95% CI, 1.16-3.65) compared with women with normal age of menopause.

Among women with premature surgical menopause, menopausal hormone therapy use (OR = 0.4; 95% CI, 0.18-0.89) and physical activity (OR = 0.41; 95% CI, 0.27-0.64) were associated with reduced sarcopenia odds, whereas comorbidities were associated with increased sarcopenia odds (OR = 1.9; 95% CI, 1.23-2.92).

“This study highlights the potential long-term musculoskeletal effects of premature surgical menopause, which causes a more abrupt and complete loss of ovarian hormones, including estrogen and testosterone, than natural menopause,” Stephanie Faubion, MD, MBA, FACP, NCMP, IF, director of the Mayo Clinic Center for Women’s Health and medical director of The Menopause Society, said in a related press release. “The use of hormone therapy until the natural age of menopause has the potential to mitigate some of the adverse long-term effects of early estrogen loss.”

Reference:

• Premature menopause linked to increased musculoskeletal pain and likelihood of sarcopenia. www.menopause.org/docs/default-source/press-release/muscle-disorders-associated-with-type-of-menopause.pdf. Published May 1, 2024. Accessed May 1, 2024.