Intergenerational abuse, childhood violence may cause earlier onset of menopause
Click Here to Manage Email Alerts
Women who experienced physical abuse in childhood or the sexual abuse of their own child reached menopause earlier than women who did not, especially if they experienced both, according to data published in Menopause.
“Over three previous papers, my co-authors and I have studied how violence in the early life course (eg, childhood abuse) is associated with early menarche among girls in a major longitudinal national study — the National Longitudinal Study of Adolescent to Adult Health (Add Health) — and how early menarche is in turn a risk factor for young women’s heightened exposure to intimate partner violence,” Holly Foster, PhD, professor of sociology at Texas A&M University, told Healio.
“Another strand of our research examines how parental incarceration influences children, and there is emerging research on how children’s incarceration and spousal incarceration affects mothers,” Foster said. “Bringing these research strands together, it seemed that — in addition to a few key studies finding women’s personal violence exposure leads to women’s earlier age of menopause — children’s violence exposure may also affect maternal reproductive aging in mid-life, even after controlling for her personal exposure.”
Data collection
To explore this, Foster and colleagues analyzed data collected from the Add Health and the Add Health Parent Study (AHPS).
Children participated in four waves of the Add Health study between 1994 and 2009, which comprehensively examined their adolescent development. Their biological, step and adoptive mothers participated in two waves of the AHPS — which surveyed their social, behavioral and health information from 1994 to 1995 and from 2015 to 2017 — following their original participation in the Add Health in 1995. Both mothers and their children reported their own exposure to violence in childhood and adulthood.
For the purposes of the present study, the researchers included 1,466 biological mothers of adult children who had reached menopause by the second wave of AHPS, reported age at menopause and were currently in an intimate relationship.
Effect of abuse on menopause
Mothers who reported physical abuse in childhood had an earlier onset of menopause compared with those who did not (linear regression coefficient, –1.6; P < .05). They were predicted to experience menopause at 46.66 years, compared with 48.26 years in mothers who reported no abuse.
There were no significant associations between intimate partner physical abuse and age at menopause, the researchers said.
Children’s experiences with sexual abuse were significantly associated with earlier onset of menopause among their mothers, such that higher frequency of abuse was correlated with younger age at menopause (linear regression coefficient, –1.39; P < .01). Mothers who did not report their own physical abuse during childhood but had children who experienced a high frequency of sexual abuse were predicted to reach menopause at 41.08 years.
“It was surprising and important to see the salience of the intergenerational effect between children’s sexual abuse and maternal earlier age of menopause,” Foster said. “We were able to incorporate a range of the mother’s child’s violence exposures, including their physical and emotional childhood abuse, their intimate partner violence and more general violence associated with community settings, but found the strongest association with childhood sexual abuse.”
Experiencing physical abuse in childhood and having children who experienced sexual abuse was significantly associated with reaching menopause earlier. Mothers who had a history of both were predicted to reach menopause at 39.48 years — 8.78 years earlier than mothers who reported no abuse.
“The results of this study suggest a midlife intergenerational weathering hypothesis in finding that both maternal childhood physical abuse and her child’s sexual abuse are associated with an earlier age of maternal menopause,” Foster and colleagues wrote. “This finding is new and suggests the studies of menopausal timing focused on women’s direct violence exposure only underestimate the total influence of violence that mothers and their children experience.”
Moving forward, the researchers suggested studies should further investigate the impact of women’s experiences of abuse.
“Ideally, future research would include questions on mother’s personal sexual abuse over the life course to further test intergenerational associations,” Foster said. “As well, these data have many strengths, and incorporating additional questions to further refine the measurement and experience of menopause (eg, vasomotor symptoms) would be an asset. These suggestions may further aid clinicians in developing interventions.”
Perspective
Back to Top
This study is important because it investigates the cumulative impact of intergenerational violence on reproductive aging. The authors showed that the combination of a mother’s history of childhood physical abuse and her child’s history of sexual abuse was associated with significantly earlier onset of menopause compared with either type of abuse alone, and compared with no history of abuse.
The impact of violence on health in general and on reproductive aging in particular has been investigated previously and has generally shown a cumulative negative effect, presumably related to chronic stress. Allostatic load is a multisystem construct that refers to the overall burden of chronic stress, which is linked with biological risk. It is theorized that this relationship is mediated by dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis. In other words, there is a physiologic cost associated with the HPA axis orchestrating allostatic adaptations to repeated, unpredictable, acute stressors. This is similar to the weathering hypothesis that postulates that chronic exposure to social and economic disadvantages leads to accelerated decline in physical health and could partially explain racial disparities in a wide array of health conditions.
Thus, poorer health outcomes and accelerated aging may result from various forms of chronic stress. Adding complexity to the issue, there are fairly robust data showing that early onset menopause is associated with adverse long-term health outcomes, multimorbidity and accelerated aging. Whether the combination of chronic adversity and early loss of ovarian function is additive in terms of the negative health effects has yet to be determined. That intergenerational violence accelerates reproductive aging should come as no surprise. The key question is how to interrupt this devastating cycle of violence. Addressing this issue will require multiple sectors, including social change, policy and education.
Collapse
Read more about
Click Here to Manage Email Alerts