The association between chronic pain and the clustering of menopausal symptoms: Evidence from a British birth cohort study

BACKGROUND: Cross-sectional studies have demonstrated an association between menopausal symptoms and chronic pain, but the direction of the association remains unknown. We assessed whether chronic pain is associated with subsequent clusters of menopausal symptoms. METHODS: We used data from the National Child Development Study, a birth cohort of people born in 1958 in England, Scotland and Wales, which has included a biomedical sweep at age 44 when chronic pain was assessed and a 20-item menopause symptom questionnaire at age 50. Chronic pain was defined as lasting longer than 3 months, and chronic widespread pain was defined as chronic contralateral upper and lower quadrant pain and spinal pain. Latent class analysis was used to define menopause symptom classes (n = 4897) and structural equation models (n = 3308) to relate chronic pain and chronic widespread pain to these classes, adjusting for confounding variables. RESULTS: We found four latent classes of menopause symptom experience at 50 years. These were a low symptom burden class, one defined by vasomotor symptoms, one by psychological symptoms and one with high symptom burden. Chronic pain and chronic widespread pain at 44 years were related to greater odds of being in the higher symptom burden classes compared with the low burden group. For example, the odds ratio (95 % confidence interval) for the high symptom burden class was 2.90 (2.21, 3.81) for chronic pain and 3.50 (2.23, 5.49) for chronic widespread pain, and for the vasomotor symptom class 1.50 (1.16, 1.94) for chronic pain and 1.93 (1.19, 3.13) for chronic widespread pain. CONCLUSION: Women with chronic pain and chronic widespread pain earlier in life may experience greater burden of menopausal symptoms and this should be considered in their clinical management.