Longitudinal study of the inception of perimenopause in relation to lifetime history of sexual or physical violence.
OBJECTIVE
To investigate of the extent to which violence over the life course accelerates the onset of perimenopause, as measured by menstrual changes.


METHODS
Prospective cohort study.


METHODS
Boston, Massachusetts.


METHODS
603 premenopausal women aged 36-45 years at baseline who completed a cross sectional survey on childhood and adult violence history.


METHODS
Time to perimenopause, defined as time in months from baseline interview to a woman's report of (1) an absolute change of at least seven days in menstrual cycle length from baseline or subjective report of menstrual irregularity; (2) a change in menstrual flow amount or duration; or (3) cessation of periods for at least three months, whichever came first.


RESULTS
Experience of abuse was associated with delayed onset of menstrual changes indicative of onset of perimenopause. Women reporting childhood or adolescent abuse entered perimenopause about 35% slower than women who reported no abuse (IRR(adj) = 0.65, 95% CI 0.45 to 0.95) after adjusting for age, age at menarche, ever live birth, ability to maintain living standard, smoking, BMI, and depression. There was a similar association among women who reported first abuse during adulthood (IRR(adj) = 0.72, 95% CI 0.28 to 1.80). These findings persisted when the cohort was restricted to non-depressed women (childhood/adolescent IRR(adj) = 0.57, 95% CI 0.36 to 0.90; adulthood IRR(adj) = 0.63, 95% CI 0.23 to 1.77).


CONCLUSIONS
This study is the first longitudinal analysis of the timing of perimenopause to show an association with a history of physical or sexual abuse. Further study of the relation between violence and reproductive aging is needed.
Department of Community Health, Brown Medical School, Providence, RI 02912, USA. Jenifer_Allsworth@brown.edu.
Jenifer E
JE
Allsworth
Sally
S
Zierler
Kate L
KL
Lapane
Nancy
N
Krieger
Joseph W
JW
Hogan
Bernard L
BL
Harlow
D000328:Adult; D000367:Age Factors; D000368:Aged; D002648:Child; D002649:Child Abuse; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008597:Menstrual Cycle / Q000502:physiology / Q000523:psychology; D047648:Perimenopause / Q000502:physiology / Q000523:psychology*; D012742:Sex Offenses; D013315:Stress, Psychological / Q000503:physiopathology; D014754:Violence