Hormonal and reproductive factors are associated with chronic low back pain and chronic upper extremity pain in women - The MORGEN study

STUDY DESIGN. Cross-sectional study of 11,428 women aged 20-59 years who were included in a postal questionnaire survey in the Dutch general population. OBJECTIVE. To examine how hormonal and reproductive factors are associated with chronic low back pain (LBP) and chronic upper extremity pain (UEP) in women. SUMMARY OF BACKGROUND DATA. Although LBP is suggested to be linked to hormonal and reproductive factors in women, results from previous studies are inconclusive. In addition, the association with chronic UEP is unknown. METHODS. Multivariate logistic regression models were used to examine associations between hormonal and reproductive factors (independent variables) and, respectively, chronic LBP, chronic UEP and combined chronic LBP/UEP. Associations were adjusted for age, level of education, working status, smoking, and overweight. RESULTS. Past pregnancy, young maternal age at first birth, duration of oral contraceptive use, and use of estrogens during menopause were associated with chronic LBP, while young age at menarche was associated with chronic UEP. Irregular or prolonged menstruation and hysterectomy were associated both with chronic LBP and chronic UEP. No positive associations were found for current pregnancy and number of children. CONCLUSIONS. In adult women, hormonal and reproductive factors are associated with chronic musculoskeletal pain in general. Factors related to increased estrogen levels may specifically increase the risk of chronic LBP.