Lifelong violence against women linked to significantly earlier menopause

The research, published in the journal Maturitas, links trauma experienced to the onset of the menopause up to 20 months earlier and an increase in hot flushes, depression and cardiometabolic health problems.

A study by the Department of Obstetrics and Gynaecology at the University of Granada has revealed that exposure to violence against women throughout life has lasting effects that extend into middle age. The research, published in Maturitas, the journal with the highest impact in this field, shows that women who have experienced violence suffer more severe menopausal symptoms and may reach the menopause up to 20 months earlier than those without such a history. The study notes that for every woman who dies as a result of violence, more than 400 suffer serious disabilities, the after-effects of which are often confused with or exacerbated by the menopause.

Analysis of the scientific evidence consistently indicates that women who are victims of any form of violence experience more pronounced menopausal symptoms. These include more intense and frequent hot flushes and night sweats (vasomotor symptoms), as well as a higher prevalence of anxiety, depression, insomnia and post-traumatic stress disorder (PTSD) in terms of psychological health. In the sexual and urogenital sphere, there is an increase in vaginal dryness, pain during sexual intercourse (dyspareunia) and urinary problems, particularly following episodes of sexual violence.

An advance of up to 20 months

One of the study's most notable findings is the link between violence and an earlier onset of the menopause. Women exposed to trauma may reach this stage up to 20 months earlier than those without such a history, which increases the risk of premature ovarian failure (POF).

A history of violence is also associated with systemic health problems in later life. In the cardiometabolic sphere, the risk of hypertension, diabetes and metabolic syndrome increases, mediated by chronic stress and inflammatory processes. In terms of bone health, the risk of osteoporosis and fractures rises. There are also greater reports of memory problems and difficulties with attention in cognitive health, linked to dysregulation of the stress axis and neuroinflammation.

Biological mechanisms and the hidden burden of morbidity

The research indicates that the mechanisms behind these effects include dysregulation of the hypothalamic-pituitary-adrenal axis and epigenetic changes caused by traumatic stress. These factors contribute to a lower quality of life in postmenopausal women across the somatic, psychological and sexual domains, creating a 'hidden burden' of morbidity.

The authors note that 'violence against women is a critical public health issue whose effects persist for decades after the assault', and therefore emphasise the urgent need to implement a trauma-informed care model in clinics specialising in midlife and menopause. This involves ensuring privacy, carrying out proactive screening for sexually transmitted infections and cervical cancer, and creating integrated care pathways linking gynaecology with mental health, internal medicine and pelvic floor physiotherapy.

Source:

University of Granada