History of abuse linked to worsening of menopausal symptoms
According to a cohort study, women who experience violence in their lifetime may experience difficulty with menopausal symptoms and have poorer long-term general well-being.
In an analysis of over 600 women, those who reported lifetime physical abuse were more likely to also report a higher average menopausal symptom assessment score in somatic domains (0.46 points , 95% CI 0.04-0.87) and psychological (0.52 points, 95% CI 0.07-0.97), said Sabrina Faleschini, PhD, of Harvard Medical School in Boston, and these partner’work.
And women who experienced sexual trauma scored nearly three points higher on the Menopause Global Rating Scale (2.81 points, 95% CI 1.05-4.56), did they declared in Menopause.
Women who experienced physical or sexual abuse were almost twice as likely to report poorer overall well-being later in life, the authors noted, adding that financial instability was also linked to menopausal symptoms. and a more serious general state of health. Specifically, study participants with a history of financial instability had a mean difference of 1.92 points on the Menopause Rating Scale (95% CI 0.49-3.34).
Faleschini’s group also reported a greater likelihood of general health deterioration later in life for women with a history of physical violence (OR 1.73) or sexual abuse (OR 2.04), while that financial instability was linked to a greater risk of poor overall health later in life. (OR 2.16, 95% CI 1.24-3.75).
“These findings highlight the lasting influence of negative experiences on women’s physical and mental health and underscore the importance of histories of psychosocial stressors when considering the health of women in their 40s.” they wrote.
Hot flashes, sleep disturbances, and sexual dysfunctions are common during perimenopause, and the authors wanted to see if traumatic experiences had an impact on these symptoms. They assessed Project Viva participants, a cohort of women enrolled during pregnancy between 1999 and 2002. Participants and their children were followed for 2 decades, with the women providing data on the health and well-being of midlife between 2017 and 2021.
During a mid-pregnancy visit, the women self-reported psychosocial stressors, including a history of physical or sexual abuse and financial instability, from infancy through their current pregnancy. About 2 decades later, these women reported their menopausal symptoms using the Menopause Rating Scale, a 44-point scale that includes scoring of somatic, psychological, and urogenital symptoms. Additionally, the women also reported on their overall well-being, depressive symptoms, and anxiety.
The researchers restricted the analysis to all women who were postmenopausal or aged 45 and over at midlife follow-up, and adjusted for covariates such as age, race/ethnicity, education level , marital status, household income and smoking status. In the end, 682 participants were included. They had a median age of 33 during pregnancy and 52 when they reported menopausal symptoms. Most study participants were Caucasian, with 80% saying they had a college degree. The latter limited the generalizability of the findings, especially to marginalized populations, the authors acknowledged.
About 37% of women reported a lifetime history of physical abuse, 8% reported sexual abuse, 11% reported financial instability, 12% reported generalized anxiety, and 16% reported depressive symptoms .
In terms of depression, a history of physical abuse and financial instability were both linked to midlife depressive symptoms. But there was no association between psychosocial stressors and generalized anxiety symptoms, the researchers said.
Limitations of the study included the retrospective assessment of psychosocial stressors and that experiences of abuse or financial instability may be underreported.
Faleschini and colleagues said future studies should focus on the effects of multiple psychosocial stressors on menopausal symptoms and overall health to identify potential health initiatives.
The study was funded by the NIH and the Pilgrim Health Care Institute.
Faleschini did not disclose any relationship with the industry. The co-authors disclosed relationships with Merck, Pfizer, Eisai, Jazz, Bayer, Arsenal Biosciences, Tango Therapeutics, and UpToDate.