ArticleJournal of general internal medicine2019
Menopausal Symptoms and Higher Risk Opioid Prescribing in a National Sample of Women Veterans with Chronic Pain.
Article in Journal of general internal medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 52 citations in OpenAlex.
- An Evidence Map of the Women Veterans' Health Literature, 2016 to 2023: A Systematic Review.JAMA network open · 2025Pooled it
- Identifying Sex Differences in Adverse Events Reported on Opioid Drugs in the FDA's Adverse Event Reporting System (FAERS).Pharmaceuticals (Basel, Switzerland) · 2026Article
- Chronic pain prevalence and severity in females before & after menopause versus males in a large multi-center database.Pain management · 2025Observational
- Estradiol protects against pain-facilitated fentanyl use via suppression of opioid-evoked dopamine activity in males.Neuron · 2025Article
- The prescribing of opioids for chronic non-cancer pain in the menopausal and postmenopausal population: a drug utilisation study in the UK.BJGP open · 2025Article
- Long-term Psychoactive Medications, Polypharmacy, and Risk of Suicide and Unintended Overdose Death Among Midlife and Older Women Veterans.Journal of general internal medicine · 2022Article
- Pain in midlife women: a growing problem in need of further research.Women's midlife health · 2022Article
- The impact of midlife on migraine in women: summary of current views.Women's midlife health · 2020Review
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundThe greatest increases in long-term opioid use and opioid-related overdose mortality in recent years have been among women in midlife. Common menopausal symptoms broadly affect health and health care utilization in midlife, but their contribution to chronic pain management during this period is unknown.
objectiveTo examine relationships between menopausal symptoms and long-term opioid prescription patterns among midlife women with chronic pain.
designCross-sectional analysis of national Veterans Health Administration medical and pharmacy records (2014-2015).
participantsWomen Veterans aged 45-64 with ≥ 1 outpatient visit and chronic pain diagnoses spanning ≥ 90 days. MAIN MEASURES: Long-term opioids (prescribed oral opioids for ≥ 90 days), high-dose long-term opioids (> 50 mg average morphine equivalent daily dose), and long-term opioids co-prescribed with central nervous system depressants (benzodiazepine and non-benzodiazepine sedative-hypnotics, gabapentin/pregabalin, muscle relaxants). Multivariable logistic regression models were used to examine associations between outcomes and menopausal symptoms (menopausal symptom-related diagnoses (i.e., "symptomatic menopausal states") on ≥ 2 encounters and/or menopausal hormone therapy, adjusting for race, age, body mass index, and mental health and substance use disorder diagnoses. KEY
resultsIn this national sample of 104,984 midlife women Veterans with chronic pain (mean age 54.5, SD 5.4 years), 17% had evidence of menopausal symptoms, 51% were prescribed long-term opioids, 13% were prescribed high-dose long-term opioids, and 35% were co-prescribed long-term opioids and central nervous system depressants. In multivariable analyses, women with menopausal symptoms had increased odds of long-term opioids (OR 1.21, 95% CI 1.18-1.26), high-dose long-term opioids (OR 1.08, 95% CI 1.02-1.13), and long-term opioids co-prescribed with central nervous system depressants (sedative-hypnotics OR 1.25, 95% CI 1.22-1.30; gabapentin/pregabalin OR 1.23, 95% CI 1.20-1.27; muscle relaxants OR 1.24, 95% CI 1.20-1.28).
conclusionsAmong midlife women Veterans with chronic pain, evidence of menopausal symptoms was associated with potentially risky long-term opioid prescription patterns, independent of known risk factors.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.