title: Hormonal and reproductive factors are associated with chronic low back pain and chronic upper extremity pain in women--the MORGEN study.
abstract: METHODS
  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.
  
  
  BACKGROUND
  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.
authors.affiliation: National Institute of Public Health and the Environment, Center for Prevention and Health Services Research, Bilthoven, The Netherlands.
authors.forename: Hanneke A H
authors.initials: HA
authors.lastname: Wijnhoven
authors.forename: Henrica C W
authors.initials: HC
authors.lastname: de Vet
authors.forename: Henriëtte A
authors.initials: HA
authors.lastname: Smit
authors.forename: H Susan J
authors.initials: HS
authors.lastname: Picavet
mesh_terms: D000328:Adult; D001132:Arm; D002908:Chronic Disease; D003276:Contraceptives, Oral / Q000008:administration & dosage; D004334:Drug Administration Schedule; D015914:Estrogen Replacement Therapy; D004967:Estrogens / Q000097:blood*; D005260:Female; D020073:Gravidity; D006801:Humans; D007044:Hysterectomy; D017116:Low Back Pain / Q000097:blood / Q000150:complications* / Q000453:epidemiology; D008423:Maternal Age; D008599:Menstruation Disturbances / Q000150:complications*; D008875:Middle Aged; D010146:Pain / Q000097:blood / Q000150:complications* / Q000453:epidemiology; D011247:Pregnancy; D015995:Prevalence
chemical_list: D003276:Contraceptives, Oral; D004967:Estrogens