Menopause could be involved in the pathogenesis of muscle and joint aches in mid-aged women

Abstract

Background

Muscle and joint aches (MJA) are frequently observed among menopausal women. They impair quality of life and are a burden to the healthcare system.

Objective

To analyze the relation between MJA and several variables related to the menopause.

Methods

In this cross-sectional study, 8373 healthy women aged 40–59 years, accompanying patients to healthcare centers in 18 cities of 12 Latin American countries, were asked to fill out the Menopause Rating Scale (MRS) and a questionnaire containing personal data.

Results

Mean age of the whole sample was 49.1 ± 5.7 years, 48.6% were postmenopausal and 14.7% used hormone therapy (HT). A 63.0% of them presented MJA, with a 15.6% being scored as severe to very severe according to the MRS (scores 3 or 4). Logistic regression model determined that vasomotor symptoms (OR: 6.16; 95% CI, 5.25–7.24), premature menopause (OR: 1.58; 95% CI, 1.02–2.45), postmenopausal status (OR: 1.43; 95% CI, 1.20–1.69), psychiatric consultation (OR: 1.93; 95% CI, 1.60–2.32) and the use of psychotropic drugs (OR: 1.35; 95% CI, 1.08–1.69) were significantly related to the presence of severe-very severe MJA. Other significant variables included: age, tobacco consumption and lower education. Self perception of healthiness (OR: 0.49; 95% CI, 0.41–0.59), private healthcare access (OR: 0.77; 95% CI, 0.67–0.88) and HT use (OR: 0.75; 95% CI, 0.62–0.91) were significantly related to a lower risk for the presence of severe-very severe MJA.

Conclusion

In this large mid-aged sample the prevalence of MJA was high, which was significantly associated to menopausal variables, especially vasomotor symptoms. This association may suggest a potential role of mid-life female hormonal changes in the pathogenesis of MJA.

Introduction

Research related to muscle and joint aches (MJA) has increased in the last decade as a consequence of its high prevalence and the increased costs (personal and institutional) they generate [1], [2], [3]. An estimated 10% of the general population suffer this complaint, mainly mid-aged women and when it is generalized and accompanied by sleep and mood problems, it is known as fibromyalgia [4]. The etiology of the fibromyalgia syndrome is unknown but it involves neurophysiological disorders related to pain perception and the modulation of mood, sleep and cognition [5]. In this sense, tricyclic antidepressants, serotonin/noradrenaline reuptake inhibitors and pregabalin have shown effectiveness in decreasing pain and fatigue [6]. On the other hand, there is the climacteric syndrome which is a group of symptoms mainly originated by decreased ovarian hormone secretion, causing vasomotor symptoms (VMS), mood disorders, sleep complaints and frequently MJA [7].

As with the climacteric syndrome, fibromyalgia is related to neurotransmission failure; hence it is not of surprise that several antidepressants be useful for the treatment of both conditions [8]. As fibromyalgia and the climacteric syndrome share similar epidemiology, etiology, symptomatology and therapy this recently lead us to propose that in some patients with fibromyalgia etiology may rely on the hormonal changes seen during the climacteric [9]. This hypothesis is not only important from a theoretical point of view yet also a clinical one owing to the fact that fibromyalgia has no successful treatment; whereas hormone therapy (HT) is highly effective for the management of the climacteric syndrome. Independent of diagnosis, MJA are relevant in both syndromes. The aim of the present study was to relate MJA with various factors related to the climacteric and determine the correlation between the intensity of MJA and climacteric symptoms. This relationship could suggest a possible role for female mid-aged hormonal changes in the etiology of MJA.