Emotional Abuse Associated With Increase in Menopausal Symptoms

Highlights:

• Women with a history of emotional abuse (exposed to undue criticism, made fun of, threats of harm etc) have a higher incidence as well as a more severe degree of menopausal symptoms
• Menopausal symptoms refer to the occurrence of hot flashes and night sweats, sleep disturbances, pain and discomfort, and vaginal dryness and painful sex
• Routine assessment of the history of emotional abuse in menopausal women can help in better management of menopausal symptoms

Having an emotionally abusive partner or spouse can be associated with increased risk and severity of menopausal symptoms in women, according to a recent study conducted at University of California, San Francisco. The findings of the study appear in JAMA Internal Medicine. Menopause refers to the decrease in female hormones that occurs naturally as the woman approaches her fifties. It starts around a year after the last menstrual period. This transition phase is associated with numerous physical and mental health issues, which need to be recognized and treated.

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Factors affecting Menopausal Symptoms

It is widely known that smoking, obesity and a sedentary lifestyle, as well as hormonal changes during menopause, are associated with menopausal symptoms.

"Traditionally, menopause symptoms have been largely attributed to biological and hormonal changes, as well as negative mood symptoms, health-risk behaviors, cardio-metabolic risk factors and chronic health conditions that occur at a higher rate during and after menopause," said first author Carolyn Gibson, PhD, a clinical research psychologist affiliated with the UCSF Department of Psychiatry.

The current study has explored whether emotional abuse and mental trauma in women could influence the risk and severity of menopausal symptoms.

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Emotional Abuse and Menopausal Symptoms

The study included 2016 women enrolled in Kaiser Permanente Northern California, an integrated health care system. The average age of the women was 61 years and majority were college educated and overweight or obese. Nearly 39 percent of participants were white, while 21 percent were black, 20 percent were Hispanic and 19 percent were Asian.

• The three forms of menopausal symptoms studied included
• Menopausal issues with sleep
• Vaginal discomfort such as dryness, irritation and painful sex; and
• Vasomotor symptoms, which includes night sweats and hot flashes
• Exposure to emotional trauma was quite common in the women sampled and included post-traumatic stress disorder (PTSD) symptoms. Nearly 23 percent (450) reported symptoms of PTSD, 16 percent (316) said they had suffered domestic violence and 19 percent (382) reported having undergone sexual assault
• One in five women reported being emotionally abused by their current or former partners, and these women had 50 percent higher risk of night sweats and were 60 percent more likely to have painful sex
• Women with symptoms of post-traumatic stress disorder (PTSD) or those having a history of sexual assault or domestic violence, had a significantly higher occurrence of menopausal pain and discomfort
• Women with PTSD symptoms had more than thrice the likelihood of sleep difficulties and more than twice as likely to have vaginal irritation.
• Women who endured sexual assault or violence by former or current partners had 40-to-44 percent higher odds of painful sex

The findings of the study, therefore, suggest that women with a history of domestic violence and emotional abuse, sexual assault and clinically significant PTSD symptoms over their lifetime have several health issues including severe menopausal symptoms

Gibson said, "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."

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Conclusion

To conclude with the remarks of Gibson, "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."

Reference:

1. Associations of Intimate Partner Violence, Sexual Assault, and Posttraumatic Stress Disorder With Menopause Symptoms Among Midlife and Older Women - (doi:10.1001/jamainternmed.2018.5233)

Source-Medindia