by the Editors of AFI
Better with age
Many things improve with age - but pain? New studies indicate that specific kinds of pain relief appear linked with the aging process. While joint pain increases with age in both men and women, abdominal pain and tension-type headaches appear to decrease with age in women. As well, migraine headaches and facial pain may diminish significantly - for some women, altogether -- after menopause.
Since these particular forms of pain also seem to peak for women during their reproductive years, scientists believe hormones may be the key factor. Studies have shown that women experience significant changes in their headache and migraine patterns based on changing levels of hormones within a regular menstrual cycle, and, particularly, during fluctuations in hormone levels, such as at first menstruation, pregnancy and menopause.
More research on the differences in chronic pain between men and women, and between the different stages of a woman's life, needs to be completed to offer a more refined picture of the interaction between a woman's cycles and her pain conditions.
HRT and pain
Preliminary research has examined the link between chronic pain conditions and HRT use in menopausal women, and so far - it doesn't look good for HRT.
In a small study examining orofacial pain, researchers found that women on HRT reported higher levels of pain than those not taking HRT. Another study using a small sample of participants has examined general levels of chronic widespread pain in those who suffer from fibromyalgia. Researchers compared survey results from women on HRT and those not on HRT, and found an increased risk of chronic widespread pain in women who were currently using HRT.
A third small study examined back pain in elderly women and compared pain levels between those currently on oestrogen therapy and those not taking oestrogen therapy. Researchers found that a significantly higher percentage of those on oestrogen therapy reported clinical back pain and impaired back function than those who had never taken oestrogen therapy.
Finally, a recent study has compared the level of pain response in postmenopausal women on HRT to those who have never taken HRT. Researchers found that women on HRT showed lower pain thresholds and tolerances generally than those women not taking HRT.
In each of the studies, researchers indicate that it is not clear if HRT is the cause of increased pain and pain sensitivity, or if those on HRT had more menopausal symptoms (including pain) to begin with. No exhaustive study has yet been completed on the topic of HRT and pain, and little is known on the relation between menopause and chronic pain conditions.
J Womens Health 1999 Apr;8(3): 313-20; Clin J Pain 2000 Jun;16(2):121-6; Expert Opin Pharmacother 2001 Nov;2(11):1839-48; Rheumatology 2002 Apr;41(4):454-7; Spine 2001 Jul 15;26(14):1606-12; Pain 2001 May;92(1-2):229-34.
This article first appeared in A Friend Indeed (Mar/Apr 2003), the newsletter for women in menopause and midlife.
