While we have identified various sociodemographic variables as factors which modulate vulnerability to menopausal symptoms, no studies (to my knowledge) have looked at how a history of intimate partner violence (IPV) or other traumatic exposures may affect susceptibility to menopausal symptoms.
A recent study looked at menopausal symptoms in 2,016 women (40 to 80 years of age) who were participating in the Reproductive Risks of Incontinence Study at Kaiser. In this cohort, 21.0% of the women reported a lifetime history of emotional IPV, 15.7% reported a history of physical IPV, 14.3% reported both emotional and physical IPV, and 19.0% reported a history of sexual assault. Overall, 22.5% of the women met criteria for clinically significant symptoms of PTSD.
After adjusting for age, race/ethnicity, educational level, body mass index, menopause status, hormone therapy, and parity, the researchers observed an association between history of trauma and increased risk for menopausal symptoms. A history of IPV and/or sexual assault increased risk of menopausal symptoms; however, this association was the most pronounced in those women with exposure to trauma which was associated with PTSD symptoms.
Women with PTSD had an increased risk of menopausal symptoms, including sleep difficulties (odds ratio [OR], 3.02; 95% CI, 2.22-4.09), vasomotor symptoms (hot flashes OR, 1.69; 95% CI, 1.34-2.12; night sweats OR, 1.72; 95% CI, 1.37-2.15), and vaginal symptoms (vaginal dryness: OR, 1.73; vaginal irritation: OR, 2.20; pain with intercourse: OR, 2.16).
It is surprising that such a high proportion of the women (22.5%) have PTSD. If a significant proportion of women who experience menopausal symptoms also experience PTSD symptoms, it is imperative that we ask midlife women about their trauma history and consider trauma-oriented mental health services, if indicated.
Ruta Nonacs, MD PhD
Associations of Intimate Partner Violence, Sexual Assault, and Posttraumatic Stress Disorder With Menopause Symptoms Among Midlife and Older Women.
Gibson CJ, Huang AJ, McCaw B, Subak LL, Thom DH, Van Den Eeden SK. JAMA Intern Med. 2018 Nov 19.