Study Links Intimate Partner Violence and Menopause Symptoms

New research is shedding light on how physical abuse can impact the severity of menopause symptoms. A Turkish study published this month in Menopause has reported that 71% of postmenopausal women reported physical abuse from their partners and 62% of postmenopausal women reported verbal abuse. Additional forms of self-reported abuse and their frequency included psychological (29%), economic (4.3%) and sexual (1.4%).

“Violence is thought to exacerbate menopausal symptoms by causing hypoestrogenism and changes in the sympathetic nervous system, hypothalamic-pituitary-adrenal axis or serotonergic pathways,” author Elif Ayfer Baltacı Yıldız, M.D., and her colleagues write in the study. “In addition, there is an assumption that psychological problems caused by violence make women more sensitive to menopausal symptoms such as pain, hot flashes, sweating, sexual complaints and so on.”

Study authors, including Yıldız, from the department of opticianry at Bingöl University in Turkey, interviewed 168 post-menopausal women about their experiences with intimate partner violence and menopause. Sixty-nine women self-reported they had experienced domestic violence. Women were found through a family health center located in eastern Turkey. The average age of the patients was 55 years old.

In the study, menopause symptom severity was measured using the Menopause Rating Scale, which consists of 11 items concerning psychological complaints, somatic complaints and urogenital complaints. The patient rates each complaint on a scale of zero to four, with four indicating the symptom is “very severe.”

Psychological menopause complaints had the most significant relationship with intimate partner violence severity, with an odds ratio of 1.25, compared with the relationship between violence and somatic complaints (OR = 0.97) and between violence and urogenital complaints (OR = 0.81).

The World Health Organization defines intimate partner violence as “abuse perpetrated by a spouse/partner that may vary in frequency and severity over time, where the man exerts power and control over the woman, including physical, verbal, sexual, and psychological abuse as well as economic coercion.”

Although domestic violence can and does occur in both men and women, it is known to disproportionately affect women and is considered a global public health problem, according to the CDC. The worldwide prevalence of domestic violence is approximately 27%. In the United States and in Turkey, where this study was conducted, prevalence in women is reported at approximately 40%. Domestic violence in relationships often goes unreported due to fear of retaliation from the abuser. In the United States, 40% of domestic violence victims never contact the police. Additionally, 44% of female homicide victims had an emergency room visit within two years of their murder.

Menopause symptoms vary from woman to woman and can be influenced by genetics, as well as external factors such as lifestyle and environment. For example, cigarette smoking is associated with early onset menopause and more severe symptoms.

“[These findings] underscore the importance of considering intimate partner violence and menopause symptoms together,” Yıldız and her colleagues conclude. “We recommend that the often overlooked presence and history of intimate partner violence during menopause in Turkish society be carefully evaluated, as it could significantly impact women's health and the way healthcare is provided.”