Early age at menarche is associated with low back pain: An analysis of existing Raine cohort data

Karin A Scott

Introduction: Low back pain (LBP) is a common problem and poses a huge burden on society with women experiencing LBP at a slightly higher prevalence than men. It is becoming more apparent that LBP is not isolated to adulthood as it is seen with increasing prevalence through the adolescent years. A female predominance has also been demonstrated in this age group. Effort should be made to understand this increasing trend of LBP throughout adolescence and identify risk factors and populations at higher risk so effective preventative strategies and treatment options can be implemented. Objectives: To explore for associations between LBP, LBP trajectories and age at menarche (AAM) in Australian adolescents using the Western Australian pregnancy cohort (Raine data). Methods: This study was a mixed longitudinal cohort study. LBP data were collected retrospectively using a questionnaire. Menarche data were collected both prospectively in the form of questionnaires and retrospectively via follow up phone calls. The menarche data was split into three established age classifications early (>12 years), normal (≥12 to >14 years) and late (≥14 years). Data were sourced from follow ups when the mean age of the cohort was 14 and 17 years old. Results: 846 female participants provided valid menarche data with 196 (23.2%) with the early AAM, 556 (65.7%) with normal AAM and 94 (11.0%) with late AAM. The mean age at menarche was 12.74 years. Low back pain prevalence was 39.8% at the 14 year follow up and 35.9% at the 17 year follow up and was most prevalent in the early and normal AAM categories at both follow ups. After excluding those with LBP prior to menarche, early menarche participants were two and a half times more likely to experience LBP (OR 2.51, 95% CI 1.68-3.75, p 0.000) at the 14 year follow up, and those with late menarche were 66% less likely to experience LBP at the 17 year follow up (OR 0.34, 95% CI 0.15-0.79, p 0.011) This remained significant after adjusting for established confounders. No association was found between age at menarche and pre-established LBP trajectories for the Raine study. Conclusion: Early age at menarche is associated with LBP while late age at menarche is protective, therefore, early menarche should be considered an independent risk factor for LBP. This has clinical significance highlighting a population in need of effective prevention and treatment strategies.

Early age at menarche is associated with low back pain: An analysis of existing Raine cohort data

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