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

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.

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.

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.

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.