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Longitudinal study of the inception of perimenopause in relation to lifetime history of sexual or physical violence
  1. Jenifer E Allsworth1,
  2. Sally Zierler1,
  3. Kate L Lapane1,
  4. Nancy Krieger2,
  5. Joseph W Hogan1,
  6. Bernard L Harlow3
  1. 1Department of Community Health, Brown Medical School, Providence, USA
  2. 2Harvard School of Public Health, Boston, USA
  3. 3Brigham and Women’s Hospital, Harvard Medical School, Boston, USA
  1. Correspondence to:
 Dr J E Allsworth
 Department of Community Health, Center for Gerontology and Health Care Research, Brown Medical School, Box G-ST, Providence, RI 02912, USA;


Study objective: To investigate of the extent to which violence over the life course accelerates the onset of perimenopause, as measured by menstrual changes.

Design: Prospective cohort study.

Setting: Boston, Massachusetts.

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

Main outcome measure: 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.

Main 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 (IRRadj = 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 (IRRadj = 0.72, 95% CI 0.28 to 1.80). These findings persisted when the cohort was restricted to non-depressed women (childhood/adolescent IRRadj = 0.57, 95% CI 0.36 to 0.90; adulthood IRRadj = 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.

  • HSMC, Harvard study of moods and cycles
  • SIPR, survey of interpersonal relationships
  • OC, oral contraceptive
  • BMI, body mass index
  • CESD, Center for Epidemiology study of depression
  • IRR, incidence rate ratios
  • HPA, hypothalamic-pituary-adrenal
  • FSH, follicle stimulating hormone
  • menopause
  • violence
  • allostatic load

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  • Funding: this study was funded by the National Institute of Mental Health, grants R01-MH577351 and R01-MH-50013.

  • Conflicts of interest: none declared.

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