Ovarian Function in Late Reproductive Years in Relation to Lifetime Experiences of Abuse

Jenifer E. Allsworth · Sally Zierler · Nancy Krieger · Bernard L. Harlow

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Intimate Partner and Family Violence Child Abuse and Trauma Menopause: Health Impacts and Treatments

Abstract

The objective of this study was to investigate the relation between violence victimization and levels of ovarian hormones during women's late reproductive years, as measured by serum levels of follicle-stimulating hormone and estradiol, which respectively rise and fall with onset of menopause. In March 1999, 732 women 36-45 years of age from the Harvard Study of Moods and Cycles cohort completed a survey of lifetime experiences of physical and sexual harm. Follicle-stimulating hormone and estradiol levels were measured during the menstrual period after entry into the cohort. Associations for violence and follicle-stimulating hormone and estradiol levels were estimated using crude and adjusted risk differences. Overall, women who experienced abuse during childhood or adolescence relative to never-abused women had a slight positive association of violence with high follicle-stimulating hormone. However, a positive association with high follicle-stimulating hormone was not observed among women whose first abuse occurred during adulthood. Age stratification indicated modification of the association between violence and low estradiol. Women 36-40 years of age had no evidence of a positive association between violence before adulthood and low estradiol, whereas first violence in adulthood was associated with an 11% increase in the estimate of risk difference [95% confidence limits (CL) = -0.14, 0.36]. Among women 41-45 years, there was a 17-23% increase in the estimate of risk difference for low estradiol, regardless of life stage at first experience of abuse (before adulthood, 95% CL = 0.06, 0.28; during adulthood, 95% CL = 0.01, 0.46). This investigation supports the credibility of a hypothesis that physical and sexual abuse may lead to neuroendocrine disruption, thereby affecting ovarian function and potentially leading to altered age at perimenopausal transition.

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References

1979Measuring Intrafamily Conflict and Violence: The Conflict Tactics (CT) Scales 1992Assessing for Abuse During Pregnancy 1999Developmental traumatology part I: biological stress systems∗∗See accompanying Editorial, in this issue.1995Abuse-Related Posttraumatic Stress Disorder 1992Assessing for abuse during pregnancy. Severity and frequency of injuries and associated entry into prenatal care 1994Urinary Catecholamine Excretion in Sexually Abused Girls 1993Early childhood abuse and limbic system ratings in adult psychiatric outpatients

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