Influence of Menopause Onset on the Progression of Lumbar Degenerative Disease: A Clinical Correlation Study.

Introduction: Lumbar degenerative disease (LDD) is one of the significant causes of chronic low back pain and disability in postmenopausal women. Although age-related degeneration has been well studied, little has been done to establish how the onset of menopause and duration since menopause affect the rate of lumbar degeneration. Menopause-induced estrogen deficiency is thought to increase the rate of degenerative alteration in intervertebral disks and vertebral structures that could affect the severity of the disease and clinical outcome. Purposes: The purpose of the study was to determine the effect of age at menopause and years since menopause on the intensity of LDD and to determine the relationship between clinical manifestations and radiographical evidence in postmenopausal females. Materials and Methods: The study was a tertiary care center-based, observational cross-sectional study which lasted 12 months at this hospital. There was a total of 50 postmenopausal women aged 45 years or older who presented with persistent low back pain. The participants were divided into the early (<45 years), normal (45-50 years), and late (>50 years) menopause. Clinical evaluation involved the severity of pain based on the Visual Analog Scale and functional limitation. The lumbar spine assessment was conducted and assessed using the standard imaging on radiological assessment, and graded on the degenerative severity. Descriptive and comparative statistical data analysis was done to analyze the data. Findings: The lumbar degeneration was moderate to severe in 74% of the respondents. The highest level of severe degeneration was observed among the early menopause group (50%), normal (23.8%), and late menopause groups (20%). The highest pain scores were seen in women who were early menopausal (6.8 ± 1.4) and progressively with radiological severity. The trend of an increase in degenerative severity was noted with the length of time which passed after menopause. The clinical-radiological correlation was positive, and the higher scores on pain were associated with more advanced degenerative grades. Conclusion: Earlier menopause and longer postmenopausal years were both positively related to the severity of LDD, the level of pain, and functional impairment. The onset of menopause seems to be a significant biological factor in the development of lumbar degeneration, which is the reason why the history of menopause should be included in the clinical assessment and prevention instead of preventive measures.