The intersection of domestic abuse and menopause: a scoping review

The interplay between menopause and domestic abuse (DA) presents a complex, under-researched nexus within women's health. Menopause, a significant physiological and psychosocial transition, may be affected by, or contribute to, women's experiences of abuse. This scoping review explores how DA during the perimenopausal and postmenopausal stages, referred to as midlife (ages 40-65) impacts symptom severity, abuse dynamics, and healthcare engagement.

A scoping review methodology following the JBI Manual for Evidence Synthesis and PRISMA-ScR guidelines. MEDLINE, CINAHL, Web of Science, and EMBASE were searched for English-language peer-reviewed studies exploring the relationship between menopause and DA with no restriction on date range. Inclusion criteria were studies involving women who were perimenopausal or postmenopausal and had experienced DA.

Of 189 unique records screened, 39 studies were included. Cross-sectional studies were most prevalent (n = 16, 41%), followed by cohort studies (n = 9, 23%) qualitative studies (n = 5, 15%) secondary data analysis (n = 3, 8%) and longitudinal studies (n = 2, 5%). There was also one each (n = 1, 2%) of clinical trial, retrospective analysis, case control study and systematic review. Three interconnected themes were identified:(1) a consistent link between experiences of DA and increased severity of menopausal symptoms (n = 34); (2) a tendency for DA to escalate or (re)emerge during midlife and menopause (n = 5); and (3) missed opportunities for DA disclosure within menopause-related healthcare encounters (n = 14). Studies spanned 14 countries, with the majority conducted in the United States (n = 16). No studies from the UK were identified.

For DA survivors there is an increase in menopausal symptoms, with profound effects on their mental, emotional, and physical health. Menopause represents both a potential risk period for DA and an opportunity for healthcare providers to identify abuse. This review highlights the urgent need for trauma-informed, menopause-sensitive healthcare practices, as well as further UK-based research.