Early menopause is associated with increased risk of osteoporosis and premature death. Stress has been linked to menstrual disorders, via neuroendocrine regulation of ovarian function, and thus may affect age of menopause. The investigators propose a 2 year epidemiologic prospective cohort study to investigate side effects of sexual and physical violence a stressors leading to menstrual disorders, and early decline in ovarian function measured by hormonal levels. The proposed study is based in a currently funded prospective cohort study on depression and depression and ovarian function decline (NIMH, NIH R01-MH50013). That study has enrolled 990 women, ages 36-44 from a population-based random sample of 6,000 women screened for premenopausal status and depression in three Massachusetts counties. Baseline observations include blood specimens during the early follicular phase of the menstrual cycle to measure follicle stimulating hormone (FSH) and estradiol. The investigators propose a telephone interview to identify frequency and patterns of experiences with violence and threats of violence over the life course. Results of the pilot study of 86 women are that, overall, 22 percent reported sexual and 30 percent reported physical violence at any time, measures that are sufficiently high for estimating their impact on reproductive health.
Specific aims are: 1) to quantify hormonal indicators of ovarian function in relation to childhood, teenage, and adult victimization in the form of actual or threatened sexual and physical violence; and 2) to quantify differences in menstrual cycle disorders in relation to childhood, teenage, and adult victimization in the form of actual or threatened sexual or physical violence. Telephone interviews using previously piloted instruments that measure lifetime experiences with sexual assault, physical abuse, and perceptions of personal safety in home and neighborhood, will provide information on the determinant scales. These interviews will also measure covariates that may modify or mediate the relation under study. These include social class and women's economic independence, social and therapeutic support, body build, diet, exercise, depression, post-traumatic stress disorder, eating disorders, and use of tobacco, alcohol and other drugs. Measures of serially collected biological markers for perimenopausal transition (FSH and estradiol levels) and self-reported retrospective and prospective measures of menstrual cycle function will be compared across categories of these determinants in multivariate regression models.
| Rayworth, Beth B; Wise, Lauren A; Harlow, Bernard L (2004) Childhood abuse and risk of eating disorders in women. Epidemiology 15:271-8 |
