Menopause and Pain – Some Days You Just Cry

Just because our periods are gone doesn’t mean we don’t still have pain associated with them. Bloating, leg cramps, headaches, lower back pain.  

And a woman’s period can start early in life. As early as 8 or 9 years old to 16 or 18. Maybe even earlier or later. I was 11 ½. 

My period pain was always bad. It was horrible from day one (1) and my body lived off Midol until my hysterectomy at age 44 (could have been 46). 

There are so many levels of pain and how much each person can take is different. If you asked ME today what my level of pain is, I would say about a 3, but I have also tolerated most of my pain for years. Some days, it’s an 8. Some days, I just cry. 

So, I became interested in how they started testing for pain because, again, we are ALL different. 

From: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1317046/ 

“Pain assessment is critical to optimal pain management interventions. While pain is a highly subjective experience, its management necessitates objective standards of care. The WILDA approach to pain assessment—focusing on words to describe pain, intensity, location, duration, and aggravating or alleviating factors—offers a concise template for assessment in patients with acute and chronic pain... 

Despite the existence of evidence-based guidelines, acute pain is not adequately addressed by health care professionals. Suboptimal pain management is not the result of lack of scientific information, considering the explosion of research on pain assessment and treatment. Yet reports documenting the inability of health care professionals to use this information continue to appear in the literature. Studies have found that two of the chief barriers for health care professionals are poor pain assessment and lack of knowledge about pain. Additionally, clinicians' personal belief systems, attitudes, and fears can directly influence the manner in which they and their patients respond to the varied dimensions of pain management.”

You should ask your doctor how they feel about pain management. 

I am telling you; the internet is an amazing place for research. Where it can lead you is bloody incredible and in searching for the earliest clinical pain studies, I found so many things. Let’s start here: 

From: https://painmanagementcollaboratory.org/pain-management-history-timeline/ 

1500 - 1300BC

Ancient Cultures

Pain outside of visible injury caused by demons or evil spirits.

Pre-Inca cultures use coca plant leaves for pain remedies.

Opium used for pain relief in Egypt, India, China, and other ancient cultures. 

460BC - 400BC

Classical Period

Pain caused by an imbalance of the four humors.

Hippocrates acknowledges usefulness in opium for treating pain.

Aside from opium or mandrake drugs, application of hot/cold therapies, blood letting, and herbal remedies applied for pain. 

300BC

Early Imperial Era

The heart senses pain, not the brain.

Acupuncture first recorded in Chinese medical text. 

50AD

Late Antiquity

Central nervous system detects pain, signaling an underlying disease that needs to be addressed to alleviate pain.

Electric fish used for headaches, arthritis, and other pains in Egypt, Rome, Greece. 

1150AD - 1300AD

Middle Ages

Pain was a punishment from god(s), with healing of it left to mortals.

First book of drug formulations introduced by Nikolaus of Salerno. More than half of the formulas are related to pain remedies.

Documented use of narcotics for painful operations. 

1350AD

Age of Exploration

Western Culture viewed medical treatments coming from the East as related to the devil.

Europeans mix narcotic substances with herbs and apply to sponge for inhalation or directly to wounds for pain relief. 

1670 - 1683

Renaissance — Enlightenment

Pain is inevitable and a sign of life.

Dutch physician Willem ten Rhijne first westerner to learn acupuncture.

Laudanum (mixture of opium and liquor) introduced by Thomas Sydenham.

Rhijne publishes essay on practical uses of acupuncture for pain relief. 

1820 - 1864

Late Industrial Era

Pain can be minimized and/or relieved.

Morphine industrially produced in Germany and the United States.

Dentist William T.G. Morton gives public demonstration of ether inhalation as a surgical anesthetic.

British Obstetrician James Young Simpson proposes use of chloroform for pain in childbirth and surgery.

S. Weir Mitchell and colleagues at Turner’s Lane Military Hospital, focus clinical research on phantom limb pain, regionalized pain, chronic pain, and neurological diseases. 

1870’s

Second Industrial Revolution

Diagnostic tests developed for specific ailments; clinicians dismiss chronic pain as a sign of mental disease.

Physicians issue concerns over morphine becoming addictive. 

Early to Mid-Twentieth Century

People reporting unexplained chronic pain not well understood, and they were often thought to be delusional or seeking drugs. 

1920’s

Psychotherapy or neurosurgery are the recommended options for pain relief. 

1947

William Livingston establishes a research-based pain clinic in U.S. 

1950’s

French obstetrician Ferdinand Lamaze develops the Lamaze method for developing pain management skills during childbirth. 

1953

The Management of Pain, by Dr. John Bonica, is the first comprehensive text book on pain treatment options around the world. 

Circa 1960s

Pain is both a psychological and physiological problem.

Ronald Melzack and Patrick D. Wall introduce the gate control theory of pain in “Pain Mechanisms: A New Theory,” which influenced how clinicians treated and discussed pain w/patients. 

Circa 1972

Pain is more than simply a symptom of disease (mental or physical). 

1970

Wilbert Fordyce introduces operant conditioning and other behavioral psychological approaches to chronic pain treatment. 

Information Era

Pain is individualized and can be helped through a multi-modal, personalized plan; need for research to determine best approaches. 

1990’s

Health community recognizes the need for a more alternative treatments to pharmacology for pain relief. 

…There was a bit more to this article, but it had to do with what the company was working on.

******************** 

Back to me:

After looking for about 20 minutes for “When was the first clinical trial for physical pain” it took me right back to where I found the first article. Ok. Bummer. 

“History of the first clinical study for menopausal physical pain” was my next Google search (after revising some words to get specific). 

Here is what I found: 

https://www.healthcentral.com/condition/menopause/menopause-chronic-pain 

To quite from the article:

Menopause and Chronic Pain

“Hormonal changes during menopause can mess with your levels of inflammation and possibly worsen other health conditions.

According to the Centers for Disease Control and Prevention, women are more likely to experience chronic pain than men. More than one in five women experience chronic pain, and over 8% experience high-impact chronic pain. Aging has additional effect on pain, with percentages rising from less than 10% of the U.S. population under the age of 30 to nearly 50% for people over the age of 45.

Women who live with chronic pain have an additional issue that comes with age: menopause, which usually begins around age 40 and can continue until your 60s and even 70s. There are a host of problems associated with this period of life, including well-known ones like hot flashes, vaginal dryness, and sleep issues. But for many women, perimenopause and menopause brings on pain, whether that is worsening of an already-diagnosed condition or new pains.”

And me again:  

SO. Where does that leave us with trying to understand what is a new pain or just an aggravating old pain? 

Let’s continue:

“Both menopause and perimenopause revolve around hormonal changes in a woman’s body, mainly estrogen, testosterone, and progesterone levels. For most women, those hormonal changes are enough to trigger a host of physical and emotional complications, But for women with chronic diseases, it opens another can of worms. "These hormones are the body’s natural steroids that help us with inflammation,” says Bruce Dorr, M.D., of Right Balance Hormone Health in Littleton, CO.

When those hormone levels fluctuate, inflammation may rise or fall, and in turn this has a potentially serious effect on people with chronic pain. “Furthermore, symptoms of perimenopause can be distressing in and of themselves, leading to anxiety and depression which are independently associated with how we feel and interpret pain,” says Dr. Dorr.”

I’m done with quoting. Please read the whole article if you like. I only needed what is pertinent to this conversation.

If I start to think about my physical pain, like right now, I start to well up. I have a current obsession with movies coming out about fentanyl etc... and I wish I could fathom taking something, anything, to rid me of every day, constant pain...aggravated by menopause, but I refuse to at this point.

What physical issues do you have that have gotten worse with menopause? Does your doctor listen, or waive it off? Male or female doctor?

I’d really like to know.