Premature menopause linked to increased musculoskeletal pain and likelihood of sarcopenia

Musculoskeletal pain is a prevalent menopause symptom, which helps explain why women typically experience more pain than men, especially around the age of 50 years. Beyond pain, muscle function and mass are also affected by menopause. A new study suggests premature surgical menopause can lead to an increased risk of muscle disorders. 

The highly publicized Study of Women’s Health Across the Nation spotlighted a number of symptoms that are common during the menopause transition. Among other findings, it confirmed that muscle stiffness complaints were most prevalent during menopause, affecting 54% of US women aged 40 to 55 years.

This is also the time when ovarian hormone levels decrease significantly. In women who have experienced premature menopause, either spontaneous or surgical, the decrease is even more prominent. In addition, testosterone levels have also been shown to fall significantly in women with premature menopause.

These facts led researchers to conduct a new study specifically designed to evaluate the effect of different types of menopause on muscle discomfort and function in late-postmenopausal women aged 55 years and older. The study, which included nearly 650 women, concluded that women experiencing premature surgical menopause were more likely to develop musculoskeletal discomfort and sarcopenia than those with natural menopause at age 45 years or older. They theorized that the pain and decline in muscle mass in the late-postmenopause stage was more closely linked to hormone deficiency than to chronologic age alone.

Abstract

Objective: Musculoskeletal disorders frequently affect postmenopausal women. This study aims to compare muscle disorders between women according to the type of experienced menopause: premature (PM) or normal age of menopause (NAM).

Methods: This was a cross-sectional study conducted in nine Latin American countries in which late postmenopausal women (55 to 70 years) were surveyed with a general questionnaire, the Menopause Rating Scale (MRS: item #4 exploring musculoskeletal discomfort), and the trength, assistance with walking, rising from a chair, climbing stairs, and falling questionnaire (risk of sarcopenia).

Results: A total of 644 women were included: 468 who had NAM, and 176 who had PM (116 spontaneous and 60 surgical). The overall mean age of the participants was 60.9 ± 4.2 years. Women who had PM experienced more musculoskeletal discomfort (33.5% vs 20.9%, P < 0.001) and a higher likelihood of sarcopenia (35.2% vs 19.9%, P < 0.001) than women who had a NAM. Women who had surgical PM exhibited a higher prevalence of severe musculoskeletal discomfort (46.7% vs 29.3%, P < 0.02) and a higher likelihood of sarcopenia (45.0% vs 27.6%, P < 0.02) than women who had a NAM. After adjusting for covariates (age, body mass index, menopausal hormone therapy use, physical activity, education, cigarette consumption, use of antidepressants, sexual activity, comorbidities, and having a partner), our logistic regression model determined that spontaneous PM was not associated with higher odds of musculoskeletal discomfort and higher odds of sarcopenia. On the other hand, women who had surgical PM were more likely to experience musculoskeletal discomforts (odds ratio: 2.26; 95% confidence interval: 1.22-4.17) and higher odds for sarcopenia (odds ratio: 2.05; 95% confidence interval: 1.16-3.65) as compared to women who experienced a NAM.

Conclusions: Women experiencing surgical PM have a higher likelihood of developing muscle disorders. This underscores the potential significance of hormonal levels in influencing musculoskeletal health during postmenopause.

María S Vallejo,  Juan E Blümel , Peter Chedraui, Konstantinos Tserotas, Carlos Salinas, Marcio A Rodrigues, Doris A Rodríguez, Claudia Rey, Eliana Ojeda, Mónica Ñañez, Álvaro Monterrosa-Castro, Gustavo Gómez-Tabares, María T Espinoza, Carlos Escalante, Alejandra Elizalde, Maribel Dextre, Andrés Calle, Sócrates Aedo. Association of muscle disorders in late postmenopausal women according to the type of experienced menopause. Menopause. 2024 Apr 30. doi: 10.1097/GME.0000000000002367. Online ahead of print.