Reproductive Factors and Pain Among Middle-Aged and Older Chinese Women: Cross-Sectional and Longitudinal Evidence from CHARLS
Year: 2026
Type: article
Abstract: Purpose: To examine reproductive factors and pain in middle-aged and older Chinese women. Methods: We used CHARLS data, combining the core survey with the Life History reproductive module. The cross-sectional analysis included 8532 women in 2018; the longitudinal analysis included 3856 women pain-free at the 2011 baseline with pain assessments in 2013, 2015, or 2018. The outcome was self-reported any pain, not clinically diagnosed chronic pain. Survey-weighted logistic regression estimated odds ratios (ORs) and 95% confidence intervals (CIs). Menopause exposures were evaluated in a postmenopausal-baseline sensitivity analysis; musculoskeletal pain sensitivity analyses tested robustness. Results: Cross-sectionally, three or more biological children (vs one, OR 1.30, 95% CI 1.06-1.61) and three or more miscarriages (vs none, OR 1.83, 95% CI 1.07-3.13) were associated with prevalent self-reported any pain in 2018. Longitudinally, 2743 women first reported pain during follow-up. Menarche after age 18 was associated with lower odds of first reported pain in the primary cumulative model (OR 0.66, 95% CI 0.49-0.87) and the discrete-time person-period analysis (OR 0.75, 95% CI 0.61-0.92). Three or more miscarriages were associated with higher odds in the primary longitudinal model (OR 3.66, 95% CI 1.01-13.32) but were imprecise and not significant in the person-period analysis. Early menopause was associated with follow-up pain only in the postmenopausal-baseline sensitivity analysis (OR 1.61, 95% CI 1.08-2.40). Cross-sectional findings were supported by musculoskeletal pain sensitivity analyses. Conclusion: Later age at menarche was associated with lower odds of self-reported follow-up pain across two complete-case longitudinal modeling approaches, a signal that requires confirmation. Higher parity and multiple miscarriages were associated with prevalent pain cross-sectionally. The longitudinal signals for multiple miscarriages and early menopause were less robust and exploratory. Because the outcome was self-reported any pain rather than clinically diagnosed chronic pain, these associations are hypothesis-generating; prospective studies with standardized, chronic-pain-specific outcomes are needed.
DOI: 10.2147/ijwh.s632451
Authors: Ning Ding, Hongmin Sun, Jie Zhao, Ying Xie, Shuna Bu, Xin Mi
Institution: Beijing Children’s Hospital
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,836
OpenAlex ID: W7224906030