Violence against women and its influence on menopausal symptoms and timing: A narrative review

Violence against women is a major public health issue and human rights concern whose effects extend into women's midlife. Accumulating research links lifetime exposure to violence with dysregulation of stress and neuroendocrine systems, potentially shaping the menopausal experience.

This narrative review synthesizes evidence on the relationship between exposure to violence and menopausal health, with emphasis on symptom burden, quality of life, long-term health sequelae, and potential shifts in the timing of menopause.

Violence is consistently associated with more frequent and severe menopausal symptoms-vasomotor, psychological (including anxiety, depression, and insomnia), and sexual/urogenital-along with poorer postmenopausal quality of life across study designs. The proposed mechanisms involve hypothalamic-pituitary-adrenal axis dysregulation, altered autonomic and serotonergic signalling, epigenetic changes, and potentially lower estrogen levels. Psychiatric comorbidities may amplify symptom perception. Other factors (e.g., demographic, lifestyle, psychosocial, and sociocultural factors) likely exert an influence but this remains underexplored. Emerging data suggest earlier menopause among women exposed to violence.

Lifetime exposure to violence is associated with a higher menopausal symptom load, diminished quality of life, and significant long-term health risks. These findings support trauma-informed, comprehensive care in midlife and highlight the need for longitudinal studies with standardized exposure/outcome measures and mechanistic biomarkers to clarify causality and guide interventions.