Childhood maltreatment and the menopause transition in a cohort of midlife New Zealand women

Objective Knowledge surrounding the link between childhood adversity and reproductive outcomes at midlife is limited. The present study examined the relationship between childhood maltreatment (childhood sexual abuse [CSA], childhood physical punishment [CPP]), and menopause status at age 40. Methods Data were gathered from female members of the Christchurch Health and Development Study, a longitudinal birth cohort of 1,265 individuals (630 females) born in Christchurch, New Zealand in 1977. Menopause status was defined by categorizing the female cohort at age 40 as either: 1) premenopausal, or 2) peri/ postmenopausal. Retrospective reports of CSA (<16 y) and CPP (<16 y) were obtained at ages 18 and 21 years. Results The analysis sample comprised n = 468 women with data recorded on both their menopause status at age 40 and history of maltreatment (<16 y), of whom 22% (n = 104) were classified as peri/postmenopausal. A statistically significant association was found between and severity of CSA and menopause status, but not between CPP and menopause status. The association with CSA was robust to control for both childhood confounding factors (<16 y) and intervening adult factors (18-40 y) associated with the menopause transition. In the fully adjusted model, women who had experienced severe CSA involving attempted/completed sexual penetration had twice the rate of entering peri/postmenopause compared with those who reported no CSA (39.0% vs 18.8%). Conclusions Severity of CSA exposure was associated with earlier menopausal transition in this female cohort. These findings are consistent with the emerging literature on the long-term health and developmental impacts of CSA.