The Scientific Relationship Between Menopause and Pain

This interesting article from  Psychology  Today  highlighting  just why  perimenopause and menopause  can bring increased pain.

“For women, the continual variation of hormonal levels through puberty, menstruation, pregnancy, and pre-and post-menopause contribute to this discrepancy in pain between the sexes. For instance, prior to puberty, there are no significant differences in the development of painful conditions between boys and girls. Afterward, the differences are dramatic, with women two to six times more likely to develop chronic pain conditions, such as headaches, irritable bowel syndrome, and fibromyalgia. There are also differences in pain levels and frequency after menopause.

The Menopausal Transition and Pain

Pain intensity tends to increase when estrogen levels are low and progesterone levels are high, as they tend to be during the second half of the menstrual cycle, possibly because there are more naturally occurring “feel good” chemicals in the brain when estrogen levels are high. You can imagine the evolutionary benefit of this: estrogen levels are highest during pregnancy and childbirth, thus providing some natural pain relief. Indeed, during pregnancy, when levels remain high and steady, studies indicate many pain conditions improve and pain sensitivity is lower.

Surprisingly, there is little research on the effects of the pre-menopause transition, called perimenopause, and menopause on pain severity and frequency. But we are beginning to learn.

The Different in Pain Before and After Menopause

One study of 101 women seen in a menopause clinic in Italy, all of whom had some form of chronic pain (headaches, fibromyalgia, arthritis, back, or abdominal pain), found that about 18 percent said their pain started after menopause; about 17 percent said it stopped after menopause; the rest said their pain that had begun prior to menopause continued after the transition. As might be expected with age, arthritic pain started or got worse after menopause in half the women.

Back Pain as it Relates to Menopause

Indeed, musculoskeletal pain, such as arthritis and back pain, have some connection to hormonal levels, with evidence showing that estrogen can affect the cartilage and fluid around the joints. This could explain why women tend to have more severe knee arthritis after menopause than men of a similar age. An analysis of seven studies also found a much greater prevalence of back pain during the perimenopausal period than either before or after menopause.

The Menopauses Effect on Pain

Another interesting finding is that women with high-intensity, high-frequency pain reported that their pain improved or remained stable after menopause, while those with low-intensity and less extended pain said it got worse. The authors of this study concluded that “menopause can act as a determinant in the evolution of painful conditions.” Translation: your pain may get better or worse after menopause, depending on its cause and severity. “

An interesting read showing that the menopause is a complex  transition that is sadly under researched.

We asked three of our expert practitioners for their  views on this issue and how a holistic approach to pain management can help.

Catherine Steele – Psychologist commented:

“We know that pain is connected to inflammation in the body. As a psychologist I work with clients on the mind body connection and we know that how we feel emotionally has a huge impact on how we experience pain. For example when we are stressed or anxious pain is experienced more acutely. Hormones also have an impact on how we feel and they impact our emotions so it can become a bit of a circle.
From a holistic perspective working with our emotions and focusing on relaxation techniques can reduce pain significantly. The menopause is a big event in a woman’s life and shouldn’t be underestimated, it represents a transition around our fertility and there are some big emotions tied into it that need to be acknowledged and talked through.”

Susan Burry

Susan Burry – Registered Dietitian added:

“Changing your lifestyle and nutrition can help when your estrogen levels start changing to reduce the symptoms, keep bone density and reduce the risk of heart disease. Aim to have 2-3 portions of calcium-rich foods per day along with your Vitamin D supplement in the winter months. Reduce caffeine and alcohol intake to manage hot flushes. Try more plant-based proteins such as nuts, peas, and lentils along with those brightly coloured fruits and veggies.”

Adam Mufti – Physiotherapist, concluded

“Menopause is indeed a complex transition and issues such as musculoskeletal and bone health can often become more apparent as both bone and muscle become porous and weak in response to the complex hormonal changes.
The most important thing in these cases is to remain active and employ a strength training programme. Numerous studies show this to be very effective at treating the pain of arthritis, improving bone and muscle health and also some evidence is now emerging that weight training can reverse early arthritic changes.
Physiotherapy can help guide you finding activity and exercise you enjoy, modify activities that are painful so that you can continue to do the things that you enjoy for longer.”