The Overlooked Link Between Sexual Trauma and Menopause Symptoms

This essay is based on personal experience and research and is not medical advice. If you are navigating chronic pain, trauma responses, perimenopause, menopause, or other health concerns, a trusted health-care professional can help you determine what care is appropriate for you.

Something I’ve noticed after spending years in survivor communities is that a lot of us are quietly (or not so quietly) dealing with significant health problems.

You might never know it by looking at us. We’re raising children, working, running organizations, speaking on stages, advocating for others, and rebuilding lives after things that once tried to destroy us.

Yet behind the scenes, many survivors I know are also managing chronic pain, migraines, digestive problems, reproductive and sexual health issues, sleep disturbances, debilitating fatigue, hormonal problems, or diagnoses that took years of persistence to be taken seriously.

That’s not a research study, but it’s an observation from within the anti-trafficking community, and I feel there’s a much larger conversation to be had about the long-term physical health of trafficking survivors and survivors of sexual violence.

But recently I started wondering about something even more specific.

What happens when women who have survived sexual violence reach perimenopause and menopause?

I’m now 45 and began entering that season last year. As my own body has begun changing, I started wondering whether trauma history could have anything to do with the way women experience this particular transition.

Is menopause simply another biological event that happens independently of everything that came before it, or can the experiences our bodies have survived over the previous decades actually matter?

I went looking for research. And it turns out I’m not the only one asking some of the questions. Who knew?

A growing body of research suggests that women with histories of violence, including sexual assault, intimate-partner violence, childhood abuse, and other forms of trauma, may experience a heavier burden of symptoms during the menopause transition.

One large study involving more than 2,000 midlife and older women examined the relationship between intimate-partner violence, sexual assault, PTSD symptoms, and menopause symptoms.

Women with clinically significant PTSD symptoms had greater odds of experiencing sleep difficulty, hot flashes, night sweats, vaginal dryness, vaginal irritation, and pain during intercourse.

A history of sexual assault itself was associated with several vaginal symptoms, including dryness, irritation, and pain with sex.

Other studies have found associations between childhood abuse or neglect and vasomotor symptoms—the hot flashes and night sweats so commonly associated with menopause.

One study in particular caught my attention because researchers did not rely solely on women describing their symptoms. They used physiological monitoring.

Among women who were already experiencing vasomotor symptoms, those with histories of childhood sexual or physical abuse had roughly 1.5 to 2 times as many objectively recorded nighttime hot flashes or night sweats.

That finding landed hard for me.

Survivors are so accustomed to having our bodies questioned. We’re told we’re anxious, emotional, stressed, overreacting, too sensitive, or simply paying too much attention to our symptoms.

Women already experience medical dismissal, and when you add a history of trauma and complicated symptoms, it can become extraordinarily easy for physical suffering to be pushed into a psychological box.