Menopausal arthralgia and longitudinal changes in sex hormones and climacteric symptoms.
4 affiliations
- 1National Clinical Research Center for Women's Health and Obstetric and Gynecologic Diseases, Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
- 2Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
- 3Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. [email protected].
- 4National Clinical Research Center for Women's Health and Obstetric and Gynecologic Diseases, Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China. [email protected].
Abstract
Background
Musculoskeletal discomfort (menopausal arthralgia) is the most prevalent and debilitating complaint during the menopausal transition. Despite its high prevalence, menopausal arthralgia has historically been overlooked, and establishing a direct association with menopause remains challenging. We aimed to study the relationship of menopausal arthralgia with respect to changes in estradiol, follicle-stimulating hormone (FSH) levels, and climacteric symptoms during the menopausal transition.Methods
Participants from a longitudinal community-based cohort in Beijing, China recruited since 2005 were studied. Women in the menopausal transition (within 5 years before or after the final menstrual period) with ≥ 2 assessment visits were included. Menopausal arthralgia was defined as the presence of moderate or severe muscle and/or joint pain affecting multiple sites, with onset or worsening during the menopausal transition, our reference condition being arthralgia symptoms reported by breast cancer patients undergoing estrogen suppression with aromatase inhibitor therapy. Participants with any history of rheumatoid arthritis or other autoimmune diseases were excluded. Menopausal symptoms and serum levels of FSH and estradiol were evaluated at each annual visit. Multivariable binary logistic regression assessed associations.Results
Among 327 women (mean age 48.48±3.65), 212 (64.83%) experienced menopausal arthralgia. Lower initial FSH levels [aOR 0.71 (95% CI 0.53, 0.96)], and a more rapid rise of FSH during the menopausal transition [aOR 2.97 (95% CI 1.02, 8.68)], increased risks for menopausal arthralgia after adjustment for age, BMI, and menopausal status. Concomitantly, higher initial estradiol levels were associated with increased risk [aOR 1.34 (95% CI 1.05, 1.71)]. The presence of hot flashes [aOR 3.58 (95% CI 2.10, 6.07)], night sweats [aOR 3.33 (95% CI 1.92, 5.76)], and vulvo-vaginal discomfort [aOR 3.19 (95% CI 1.86, 5.46)] was also associated with menopausal arthralgia after covariate adjustment.Conclusions
Menopausal arthralgia was associated with rapid hormonal fluctuations, characterized by a higher longitudinal rate of FSH change and lower initial FSH levels, alongside higher initial estradiol levels. Given its strong association with classic climacteric symptoms, menopausal arthralgia should be recognized as an integral component of the menopausal syndrome.
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BibTeX
@article{xie2026menopausal,
title = {{Menopausal arthralgia and longitudinal changes in sex hormones and climacteric symptoms.}},
author = {Zhuolin Xie and Ruiyi Tang and Feiling Huang and Penghui Feng and Yubo Fan and Xuanjin Yang and Jingbo Huang and Xiaonan Ma and Qi Yu and Eu-Leong Yong and Rong Chen},
journal = {BMC medicine},
year = {2026},
month = aug,
doi = {10.1186/s12916-026-05118-x},
url = {https://europepmc.org/article/MED/42972379},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Menopausal arthralgia and longitudinal changes in sex hormones and climacteric symptoms.
AU - Zhuolin Xie
AU - Ruiyi Tang
AU - Feiling Huang
AU - Penghui Feng
AU - Yubo Fan
AU - Xuanjin Yang
AU - Jingbo Huang
AU - Xiaonan Ma
AU - Qi Yu
AU - Eu-Leong Yong
AU - Rong Chen
PY - 2026
DA - 2026/08/01
JO - BMC medicine
DO - 10.1186/s12916-026-05118-x
UR - https://europepmc.org/article/MED/42972379
AB - Background Musculoskeletal discomfort (menopausal arthralgia) is the most prevalent and debilitating complaint during the menopausal transition. Despite its high prevalence, menopausal arthralgia has historically been overlooked, and establishing a direct association with menopause remains challenging. We aimed to study the relationship of menopausal arthralgia with respect to changes in estradiol, follicle-stimulating hormone (FSH) levels, and climacteric symptoms during the menopausal transition.Methods Participants from a longitudinal community-based cohort in Beijing, China recruited since 2005 were studied. Women in the menopausal transition (within 5 years before or after the final menstrual period) with ≥ 2 assessment visits were included. Menopausal arthralgia was defined as the presence of moderate or severe muscle and/or joint pain affecting multiple sites, with onset or worsening during the menopausal transition, our reference condition being arthralgia symptoms reported by breast cancer patients undergoing estrogen suppression with aromatase inhibitor therapy. Participants with any history of rheumatoid arthritis or other autoimmune diseases were excluded. Menopausal symptoms and serum levels of FSH and estradiol were evaluated at each annual visit. Multivariable binary logistic regression assessed associations.Results Among 327 women (mean age 48.48±3.65), 212 (64.83%) experienced menopausal arthralgia. Lower initial FSH levels [aOR 0.71 (95% CI 0.53, 0.96)], and a more rapid rise of FSH during the menopausal transition [aOR 2.97 (95% CI 1.02, 8.68)], increased risks for menopausal arthralgia after adjustment for age, BMI, and menopausal status. Concomitantly, higher initial estradiol levels were associated with increased risk [aOR 1.34 (95% CI 1.05, 1.71)]. The presence of hot flashes [aOR 3.58 (95% CI 2.10, 6.07)], night sweats [aOR 3.33 (95% CI 1.92, 5.76)], and vulvo-vaginal discomfort [aOR 3.19 (95% CI 1.86, 5.46)] was also associated with menopausal arthralgia after covariate adjustment.Conclusions Menopausal arthralgia was associated with rapid hormonal fluctuations, characterized by a higher longitudinal rate of FSH change and lower initial FSH levels, alongside higher initial estradiol levels. Given its strong association with classic climacteric symptoms, menopausal arthralgia should be recognized as an integral component of the menopausal syndrome.
SN - 1741-7015
ER -