Association Between Self-Reported Climacteric Symptoms and Pain Intensity: A Cross-Sectional Study of 6000 Japanese Men and Women

Background/Objectives: The prevalence of pain increases with age, particularly in middle-aged women, when sex hormone levels fluctuate drastically. While climacteric symptoms and their relationship with pain have been extensively studied in women, it remains unclear whether these symptoms and their association with pain are limited to women. This study aimed to investigate the association between climacteric symptoms and pain in both women and men. Methods: A cross-sectional online survey using a non-probability quota panel conducted in March 2024 assessed the presence, location, and intensity of pain during the past 28 days (numerical rating scale ≥ 1, irrespective of pain duration) among 6000 Japanese adults aged 30–59 years (3000 women, 3000 men). Climacteric symptoms were assessed using the Simplified Menopausal Index for women and the Aging Males’ Symptoms scale for men. Quality of life was assessed using the EQ-5D-5L. Pain intensity was analyzed only in participants with pain (433 women, 488 men). Results: As symptom scores increased, both men and women showed higher pain prevalence and intensity and lower quality of life. Symptom scores were positively correlated with pain intensity in both sexes (Spearman’s ρ = 0.35 in women, 0.39 in men), with no evidence of a sex difference (interaction p = 0.991). Somatic scores showed the strongest associations (standardized β = 0.21 in women, 0.22 in men), followed by vasomotor symptoms in women (β = 0.16) and psychological symptoms in men (β = 0.20). The associations remained after excluding pain-related items. Conclusions: Climacteric symptoms were associated with pain intensity in both men and women, without clear evidence of a sex difference. Causality cannot be inferred from this cross-sectional design; prospective studies are needed.