Chronic pain prevalence and severity in females before & after menopause versus males in a large multi-center database.

Aims: This observational study aimed to explore the prevalence and severity of chronic pain in menopausal-aged females.

Materials & methods: We identified participants in the NIH-sponsored All of Us database with a diagnosis of chronic pain. We examined the severity of pain based on numeric rating scale score (NRS). Among those with chronic pain, we generated four sub-cohorts: females ≥ 51 years old who were menopausal, females 18-50 years who were considered pre-menopausal, and age matched male cohorts.

Results: The 53,289 participants were separated into four cohorts by age and sex: females 18-50 (10,269), females ≥ 51 (20,182), males 18-50 (4,989), and males ≥ 51 (17,849). Both older females and older males had lower pain levels than the sex-matched 18-50 group (p < 0.001). Findings were consistent in White, Black, and non-Hispanic cohorts. When comparing older adults, females ≥ 51 had higher pain levels than males ≥ 51 (p < 0.001).

Conclusions: We found that independent of sex, NRS scores were lower in older adults compared to younger cohorts. Older women however had more pain than their male counterparts. These findings have implications for the design of patient-tailored therapeutic treatments and warrant further exploration of physiological and psychosocial causes.