Intimate partner violence (IPV), sexual assault, and symptoms of posttraumatic stress disorder (PTSD) may be associated with menopause symptoms and experiences, according to research published in JAMA Internal Medicine.
Because there is little known about traumatic exposures and their association with health problems among midlife and older women, researchers examined associations between IPV and PTSD with menopause.
Data from 2000 women age 40 to 80 years in the Kaiser Permanente Northern California health care system were included in a cross-sectional analysis, examining lifetime physical or emotional IPV, sexual assault, and current symptoms of PTSD. In addition, participants submitted questionnaires on difficulty sleeping, vasomotor symptoms, and vaginal symptoms.
Lifetime IPV (21.0%), sexual assault (15.7%), and current PTSD symptoms were all common among participants (22.5%) and were significantly associated with increased risk for disruptive menopause symptoms. Emotional IPV and PTSD symptoms were associated with difficulty sleeping, vasomotor symptoms, and vaginal symptoms, even when adjusting for age, ethnicity, education, body mass index, menopause status, hormone therapy, and parity. Physical IPV was associated with night sweats and sexual assault was associated with vaginal symptoms.
The study had several limitations, including that longitudinal trends and temporal associations between variables could not be determined using the cross-sectional data. It also remains unknown whether PTSD symptoms are associated with IPV and/or sexual violence in women who report both exposures. Finally, previous PTSD diagnoses and trauma treatment were not determined.
Researchers stated that, “These findings point to the need for recognition of the prevalence and importance of traumatic exposures and symptoms of PTSD by clinicians caring for midlife and older women, and for efforts to provide trauma-informed care for women across the aging spectrum.” They suggest routine assessment of traumatic exposures and PTSD symptoms as well as trauma-informed care in the clinical management of menopause symptoms.
Gibson CJ, Huang AJ, McCaw B, Subak LL, Thom DH, Van Den Eeden SK. Associations of intimate partner violence, sexual assault, and posttraumatic stress disorder with menopause symptoms among midlife and older women [published online November 19, 2018]. JAMA Intern Med. doi:10.1001/jamainternmed.2018.5233