Climacteric· 2026Q1
Chronic pain at midlife
- 1citations
- Q1SCImago
- 2026year
Short summary
Menopause-related hormonal changes, particularly estradiol fluctuations, interact with musculoskeletal degeneration and neuro-immune sensitization to amplify pain perception and maintenance in approximately half of midlife women.
AI-generated from the title and abstract; the full text is not read.
Key points
- Estradiol fluctuations during menopause interact with musculoskeletal degeneration and neuro-immune sensitization to worsen chronic pain.
- Around 50% of midlife women experience chronic pain, often alongside other syndromes like fibromyalgia or migraine.
- The menopausal transition can increase vulnerability to pain, sleep disruption, mood disturbances, and fatigue.
- Effective management requires integrated, multidisciplinary, and culturally sensitive approaches tailored to individual women.
AI-generated from the title and abstract; the full text is not read.
Abstract
Chronic pain disproportionately affects women and reproductive milestones influence its clinical manifestation. Mechanistic pathways underlying pain are determined by numerous biopsychosocial factors, the most important being age, hormonal changes and mental health. Menopause-related changes in estradiol interact bidirectionally with musculoskeletal degeneration, neuro-immune sensitization, neuroendocrine responses and other intrapersonal and socio-cultural vulnerabilities, collectively amplifying pain perception and maintenance. Approximately half of midlife women experience chronic pain often with overlapping chronic pain syndromes (e.g. fibromyalgia, migraine, chronic pelvic pain) requiring an integrated management approach. The menopausal transition may coincide with an increased vulnerability to pain and vasomotor symptoms, sleep disruptions, mood disturbances, brain fog and fatigue, which may contribute overall to the pain experience. Chronic pain is a major health issue that is often under-recognized, underdiagnosed and inadequately treated. The aim of the 2026 International Menopause Society White Paper is to provide an overview of the current evidence on the most common midlife chronic pain syndromes causing significant disability and impairing quality of life. This article provides an updated synthesis of chronic pain in menopausal women, encompassing its neurobiological mechanisms and clinical management, and the influence of cultural factors, lifestyle interventions and hormonal therapies. The goal of the White Paper is to raise awareness of midlife women's pain experience and to support clinicians and policymakers in implementing culturally sensitive, personalized approaches. A proactive attitude is essential to guide women through multidisciplinary pathways of care that reflect the multidimensional nature of chronic pain, with the ultimate goal of promoting healthy longevity and gender equity.
The authors' abstract, as published at the source. Climacteric, 2026 · DOI ↗
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Field: Anesthesiology and Pain Medicine
Anesthesiology and Pain MedicineMedicine