The association between age at menarche and chronic pain outcomes in women: the Tromso Study, 2007 to 2016

Sex differences in chronic pain are well established with documented predominance in women. This study assessed relationships between age at menarche and chronic pain, site-specific chronic pain, pain characteristics, and chronic widespread pain (CWP). We used data from the Tromso Study conducted in 2007 to 2008 and 2015 to 2016 (Tromso 6 and Tromso 7 waves) including participants aged 30 to 99 years. The associations between age at menarche and chronic pain were examined in Tromso 6 (n = 6449), Tromso 7 (n = 5681), and the combination of Tromso 6 and Tromso 7 (n = 12,130). Tromso 7 data were used further to examine the associations between age at menarche and site-specific chronic pain, 4 pain characteristics (pain duration, pain intensity, episode duration, and episode frequency), and CWP. All analyses were adjusted for body mass index, age, and economic status of the household in childhood. Lower age at menarche was associated with an increased risk of chronic pain in all 3 samples (risk ratio for each year delay in menarche 0.98, 95% CI [0.97 to 0.99] across samples). Risk differences were -0.014, CI 95% (-0.02 to -0.005) in Tromso 6, -0.011, CI 95% (-0.02 to -0.02) in Tromso 7, and -0.012, CI 95% (-0.02 to -0.01) in the combined sample. Age at menarche was significantly associated with chronic pain in the neck, abdomen, and both arms, and CWP. Of the 4 pain characteristics, pain duration was statistically significant. We conclude that early menarche is an independent risk factor for pain across a broad spectrum of pain outcomes.