Arthralgia in midlife Singaporean women: the Integrated Women’s Health Program (IWHP)

Abstract

Objective

Arthralgia is a common menopausal complaint in midlife women, and its causes remain unclear. We examined the prevalence of menopausal arthralgia with various factors including sleep quality, depression/anxiety, muscle strength and physical performance among midlife Singaporean women.

Methods

The Integrated Women’s Health Program (IWHP) comprised 1120 healthy, community-dwelling women of Chinese, Malay or Indian ethnicities (aged 45–69 years) attending well-women clinics at the National University Hospital, Singapore. Sociodemographic, menopausal, reproductive and health data were obtained with validated questionnaires. Muscle strength, physical performance and dual-energy X-ray absorptiometry were measured. Women with moderate to very severe symptoms using the Menopause Rating Scale were classified as having arthralgia. Multivariable logistic regression analyses examined risk factors for arthralgia.

Results

One-third of the participants reported arthralgia, and 12.7%, 16.2% and 71.2% were in the premenopausal, perimenopausal and postmenopausal period, respectively. Menopausal symptoms, such as vaginal dryness (adjusted odds ratio [aOR]: 2.64, 95% confidence interval [CI]: 1.64, 4.24) and physical/mental exhaustion (aOR: 2.83, 95% CI: 1.79, 4.47), were independent risk factors for arthralgia. Poor muscle strength (aOR: 2.20, 95% CI: 1.29, 3.76), obesity (aOR: 1.94, 95% CI: 1.13, 3.32) and rheumatoid arthritis (aOR: 7.73, 95% CI: 4.47, 13.36) were also independently associated with arthralgia after adjustment for confounders.

Conclusions

Arthralgia in midlife Singaporean women was associated with menopausal symptoms of vaginal dryness and physical and mental exhaustion. Women with poor muscle strength were more likely to experience menopausal arthralgia.

摘要

目的: 关节痛是中年妇女常见的更年期疾病, 其病因尚不清楚。我们研究了新加坡中年妇女更年期关节痛的患病率, 包括睡眠质量、抑郁/焦虑、肌肉力量和身体表现等多种因素。

方法: 综合妇女健康计划(IWHP)包括1120名健康的、居住在社区的华裔、马来族或印度裔妇女(年龄45-69岁), 她们在新加坡国立大学医院的健康妇女诊所就诊。通过经验证的问卷获得社会人口学、更年期、生殖和健康数据。测量肌肉力量、身体机能和双能X线吸收仪。使用更年期评定量表, 有中度至非常严重症状的女性被归类为关节痛。多变量逻辑回归分析检查了关节痛的危险因素。

结果: 三分之一的参与者报告有关节痛, 12.7%、16.2%和71.2%分别发生在绝经前、围绝经期和绝经后。更年期症状, 如阴道干燥(调整比值比[aOR]:2.64, 95%置信区间[CI]:1.64,4.24)和身心疲惫(aOR:2.83, 95%CI:1.79, 4.47), 是关节痛的独立危险因素。校正混杂因素后, 肌力差(aOR:2.20, 95%CI:1.29, 3.76)、肥胖(aOR:1.94, 95%CI:1.13, 3.32)和类风湿性关节炎(aOR:7.73, 95%CI:4.47, 13.36)也与关节痛独立相关。

结论: 新加坡中年妇女的关节痛与阴道干燥和身心疲惫的更年期症状有关。肌肉力量较差的女性更容易出现更年期关节痛。

Keywords:

• Arthralgia
• joint and muscular pain
• menopause
• muscle strength
• Integrated Women’s Health Program

Acknowledgements

The authors would like to thank the women of the Integrated Women’s Health Program (IWHP) for participating in the study and for giving their time and energy for the progress of science. They would also like to thank study coordinators Win Pa Pa Thu, Ho Kum Chue, Chua Seok Eng and Poon Peng Cheng for their efforts in participant recruitment and data collection. The authors are also grateful to Ms Tan Sze Yee for performing the dual-energy X-ray absorptiometry scans, and to Dr Li Jun for handling finance and procurement.

Ethical statement

The work was approved by the Domain Specific Review Board of the National Healthcare Group, Singapore (reference number 2014/00356). All participants provided written informed consent upon enrolment.

Potential conflict of interest

The authors declare no competing or financial conflicts of interest.

Data availability statement

De-identified data are available upon reasonable request to the Integrated Women’s Health Governance Committee via the corresponding author: ([email protected]).

Additional information

Funding

This study was funded by the Singapore National Medical Research Council [grant number NMRC/CSA-SI/0010/2017] (to E.L.Y.).