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Objective  To assess the relationship between abdominal pain severity during the menopausal transition (MT) and age, MT stage, reproductive biomarkers, stress biomarkers, and stress perceptions.    Methods  Women ages 35–55 were recruited from multiethnic neighborhoods in the greater Seattle area from 1990 to 1992, for an original study cohort of 508. From 1990 to 2013, a subset of this cohort consented to ongoing annual data collection by annual health questionnaire, health diary, and daily menstrual calendar. Beginning in 1997, a portion of these women also provided a first morning voided urine specimen to be assayed for levels of estrone glucuronide (E 1 G), follicle stimulating hormone (FSH), testosterone, cortisol, norepinephrine, and epinephrine. To identify how changes in abdominal pain severity changed over time in relation to age, MT stage, reproductive biomarkers, stress-related biomarkers, and stress-related perceptions, mixed effects modeling was used.    Results  In a univariate model, E 1 G ( p  = 0.02) and testosterone (p = 0.02) were significantly and negatively related to abdominal pain severity, while perceived stress ( p  = 0.06), tension ( p  <  0.001), and anxiety (p <  0.001) were significantly and positively associated. In a multivariate model, increasing age ( p  = 0.001) and E 1 G ( p  = 0.04) were negatively associated with abdominal pain severity, and anxiety (p = 0.00) positively associated. Testosterone did not improve the fit to the final model, nor did tension or perceived stress.    Conclusions  These results suggest that age, anxiety, and E 1 G each show a significant association with abdominal pain severity in the MT. In contrast, stress perception, tension, testosterone, stress biomarkers, and MT stage do not. These factors should be evaluated further in research on abdominal pain experienced during the MT and early postmenopause years.

Abdominal pain during the menopause transition and early postmenopause: observations from the Seattle Midlife Women’s Health Study