The development of
pain is common in midlife, resulting in increased health care utilization and costs. The aim of this study was to determine the longitudinal trajectory of overall bodily
pain among women during the transition between the reproductive years and menopause. We conducted analyses on a community-based, longitudinal cohort of women enrolled in the Study of Women's Health Across the Nation. One thousand four hundred ninety-five women met inclusion criteria, including: 1) defined date of the final menstrual period (
FMP), and 2) complete data on Short Form-36 bodily
pain. The primary exposure was time to/from the
FMP. The primary outcome was the rate of change in Short Form-36 bodily
pain, measured on a scale of 0 to 100 with 100 being the most severe
pain. We performed within-person trajectory analyses using piecewise regression following nonparametric modeling of functional forms. Mean bodily
pain score at the time of the
FMP was 29. Mean bodily
pain increased at a rate of .26 per year during the transmenopause (the interval spanning 4.5 years before the
FMP through .5 years after the
FMP), and decreased at a rate of .23 per year after that. Depression and sleep problems were associated with greater increases in
pain during the late reproductive years, whereas
abdominal cramps at baseline predicted greater decreases in
pain during the late reproductive years.
PERSPECTIVE: This article shows that bodily
pain increases during the transmenopause and then diminishes during postmenopause. These differences may reflect differences in underlying mechanisms of
pain in the 2 periods. Although mean changes were small and unlikely to be clinically meaningful, the magnitude of change varied across subgroups of women.