Study: Abusive, traumatic relationships may worsen menopause symptoms

by WV Marshall

As if the night sweats, painful sex and hot flashes aren’t enough during menopause, a recent study indicates emotional abuse by a spouse or partner may exacerbate menopause symptoms.

“The data show that experience of domestic violence and emotional abuse, sexual assault and clinically significant PTSD [post-traumatic stress disorder] symptoms are common, and may affect women’s health across the lifespan,” said lead author Carolyn Gibson, a clinical research psychologist at the University of California in San Francisco.

“Stress related to emotional abuse and other traumatic exposures may influence the hormonal and physiological changes of menopause and aging, affecting biological susceptibility as well as the subjective experience of these symptoms,” she said.

While the study can’t prove a direct cause-and-effect relationship, the findings indicate “routine assessment and recognition of PTSD symptoms and lifetime traumatic exposures when women are seen by health care providers may enhance the effective management of menopausal symptoms,” Gibson said in a news release on the study published in 2018 in JAMA Internal Medicine.

Gibson and her team looked at three types of menopause symptoms among the 2,016 participants: sleep difficulties, vaginal discomfort (such as dryness, irritation and painful sex) and vasomotor symptoms, which includes night sweats and hot flashes.

Menopause symptoms typically have been attributed largely to biological or hormonal changes (as well as negative moods or chronic health conditions), but the study’s researchers have added stress brought on by emotional abuse or other trauma as a contributor to hormonal changes that affect menopause.

In their study, researchers found that one in five had been emotionally abused by a former or current partner. The study indicated these women had 50 percent higher odds of night sweats and 60 percent higher odds of painful sex. As well, menopausal pain and discomfort were pointedly higher in women who had symptoms of PTSD or were victims of sexual assault or domestic violence, the findings showed.

“Stress related to emotional abuse and other traumatic exposures may influence the hormonal and physiological changes of menopause and aging, affecting biological susceptibility as well as the subjective experience of these symptoms,” she said.

Traumatic exposures, especially emotional abuse and PTSD symptoms, were “surprisingly common” in this study’s sample, Gibson said. She described participants as “relatively healthy, well-educated and with better than average access to health care.”

Twenty-one percent of women said they had been emotionally abused by their former or current partner while 23 percent reported symptoms that matched a diagnosis of PTSD, 16 percent said they were or had been victims of domestic violence and 19 percent had experienced sexual assault.

“Our findings suggest that routine assessment and recognition of PTSD symptoms and lifetime traumatic exposures when women are seen by health care providers may enhance the effective management of menopausal symptoms,” Gibson said.

Study co-author Brigid McCaw, medical director of the Kaiser Permanente Family Violence Prevention Program, said the findings “support the recent U.S. Preventive Services Task Force recommendation to screen for emotional or physical abuse given the significant and long-lasting health impact.”