The association between smoking and joint pain in women attending a specialized menopause clinic

OBJECTIVE: Joint pain is a common menopausal symptom, but remains poorly understood. Smoking has an anti-estrogenic effect and is linked to pain syndromes. This study evaluated whether smoking is independently associated with joint pain in menopausal women. METHOD: This study was a cross-sectional analysis of survey data from 371 menopausal women attending a Canadian menopause clinic (2017-2019). Participants self-reported symptom severity, medical history and lifestyle factors. Moderate to severe joint pain was defined as a symptom score ≥2 on a 5-point scale. Logistic regression assessed associations between smoking and joint pain, adjusting for age, estrogen use, alcohol consumption, obesity and depression. RESULTS: Moderate to severe joint pain was reported by 52% of participants. Smoking was significantly associated with joint pain in both univariate (odds ratio [OR] 2.32, 95% confidence interval [CI]: 1.15-5.03) and multivariate (OR 2.18, 95% CI: 1.05-4.82) models. Joint pain was also associated with hot flashes, mood symptoms and fatigue. Age, estrogen use, obesity, depression, alcohol use and sexual activity were not significantly associated. CONCLUSION: Smoking is independently associated with joint pain in menopausal women. While the underlying mechanisms remain unclear, this association supports the hypothesis that estrogen-related pathways play a role in menopausal joint symptoms and highlights smoking as a potential modifiable risk factor.