Chronic pain increases the risk of severe menopausal symptoms

The study is based on data from the British National Child Development Study. Chronic pain (>3 months) and chronic widespread pain (pain in contralateral upper and lower body quadrants as well as back pain, including buttock pain) were recorded at age 44, while menopausal symptoms were assessed at age 50. The questionnaire covered 20 symptoms, including hot flushes, sleep problems, mood swings, urogenital complaints, and muscle and joint pain. A total of 3,308 responses were included in a latent class analysis, which identified four groups: low symptom burden, vasomotor symptoms, psychological symptoms, and high symptom burden.

The results showed that muscle and joint pain was the most frequently reported symptom and was present in all four groups, although to varying degrees. Women who reported chronic pain at age 44 had almost three times the likelihood of belonging to the high symptom burden group compared with women without pain. A similar, but weaker, association was seen for the groups with vasomotor symptoms and psychological symptoms. Among women with chronic widespread pain, the risk of belonging to the high symptom burden group was even higher, and somewhat lower for the vasomotor symptom group. Even after adjusting for factors such as socioeconomic status, prior health, mental health, and physical activity, these associations remained strong.

The researchers point out that several of the most reported symptoms, such as joint pain and sleep problems, may reinforce each other and thereby create a more complex clinical picture. Sensitivity analyses showed that even when joint pain was excluded, the risk of a high symptom burden remained more than twice as high among women with chronic pain. This suggests that pain history plays an independent role in the development of extensive menopausal symptoms.

The researchers conclude that chronic pain is an important risk factor for a substantial burden of menopausal symptoms. The findings highlight the need for increased attention to women going through menopause—both in research and in clinical practice.

Catherine Borra, Rebecca Hardy. The association between chronic pain and the clustering of menopausal symptoms: Evidence from a British birth cohort study. Maturitas 2025.