By: Aneesh de Vos and Dr. Helen Douglas
By 2025, an estimated one billion of us will be going through menopause (Hill, 1996). The World Health Organisation, whilst recognising that it is a part of the continuum of life also considers that it is affected by societal and cultural norms (2022). In recent years, the topic of menopause has been discussed extensively and research is gaining traction. Research highlighting both menopause and adverse childhood experiences (ACEs) is in its infancy – a paper by Kapoor et al (2020) explores the correlation between the symptomology of menopause and the trauma response resulting in more burdensome symptoms. It further suggests a need for those who are experiencing severe menopausal symptoms to be screened for ACEs by their health care providers.
“My mental health started to rapidly spiral downwards, but no-one made the link between my history of CSA and menopause” (de Vos & Douglas, 2022).
If we consider that, “Emotions and physical sensations that were imprinted during the trauma are experienced not as memories but as disruptive physical reactions in the present” (van der Kolk, 2015, p.206) then it is not surprising menopausal symptoms can be mistaken for a resurgence of the symptoms of PTSD (de Vos & Douglas, 2022). A lack of a felt sense of safety can arise and exacerbate old patterns of feeling out of control in a body that no longer can be relied upon to respond in its usual way. The unpredictability of peri/menopausal symptoms can and do reflect the childhood experience of sexual abuse – “peri-menopause made me feel out of control, and that was triggering for me” (de Vos & Douglas, 2022). We believe that this is a fertile ground for shame to become further embedded – accentuating narratives of the past.
One in five women report being sexually abused as children (World Health Organisation, 2022) and that is only a reported figure. How many have not been reported? The isolation experienced through trauma in relation to childhood abuse where somatic changes occur (Herman, 1992) can be further exacerbated in the peri/menopausal response. A changed physical state can be confusing and frightening – even Freud reflected in his work, how the trauma response felt as if a person had been possessed (Bonaparte et al., 1954). The disconnect of how we knew our bodies to how are bodies are reacting creates the collision of trauma and menopause (Kemp, 2021; de Vos & Douglas, 2022).
“I experienced night sweats & panic attacks which I assumed were related to my PTSD. But it was peri-menopause” (de Vos & Douglas, 2022).
People who are working to adapt to their peri/menopausal bodies through medical or non-medical support are also affected by cultural messages (World Health Organization, Menopause, 2022). Whilst we can highlight the need for a wider conversation in the mainstream to be more compassionate towards peri/menopausal changes, those who have experienced CSA can often feel marginalised and judged within their culture (Ellis, 2020).
As this blog shows, CSA is prevalent globally and menopause can and does reignite PTSD symptoms. If we are to support the telling of the “secrets too terrible for words” (Herman, 1992, p.96) then we need to ask society to look beyond their own sensitivities and widen the peri/menopause conversation for all.
References:
de Vos, A. & Douglas, H. (2022) Online Inquiry: CSA survivors awareness of menopause. White Paper, p. 4-6. Dignified Menopause Global Initiative.
Bonaparte, M., Freud, A. & Kris, E. (1954) The Origins of Psychoanalysis. Letters to Wilhelm Fliess, Drafts and Notes; p. 1887-1902, trans. E. Mosbacher and J. Strachey. Basic Books. New York.
Ellis, K., (2020) Blame and Culpability in Children’s Narratives of Child Sexual Abuse. Child Abuse Review. Volume 28, Issue 6 p. 405-417.
Herman, J. (1992). Trauma and Recovery. The Aftermath of Violence – From Domestic Abuse to Political Terror. Basic Books.
Hill, K. (1996). The demography of menopause. Maturitas p. 113-27.
Kapoor, E. Okuno, M. et al. (2020). Association of adverse childhood experiences with menopausal symptoms: Results from the Data Registry on Experiences of Aging, Menopause and Sexuality (DREAMS). Maturitas, Elsevier.
Kemp H.F. (2021). Surgical Menopause: Not Your Typical Menopause. Flying Stoat Books, UK.
World Health Organization (2022) Menopause. www.who.int/news-room/fact-sheets/detail/menopause
World Health Organisation (2022) Child maltreatment. www.who.int/news-room/fact-sheets/detail/child-maltreatment
van der Kolk, B. (2014). The Body keeps the Score. Brain, Mind, and Body in the Healing of Trauma. Penguin Books, New York.
Aneesh de Vos and Dr Helen Douglas are independent researchers who also provide training for the helping professions on the subject of “The Collision of Trauma and Menopause”. Their book, under the same name, is due to be published in 2024. Their holistic approach explores the impact through a psychosocial lens, creating a discourse to further deepen awareness of the relationship between trauma & peri/menopause.
Aneesh is currently studying for her Doctorate in Psychological Trauma. She is an established therapist and supervisor who specialises in trauma. Helen’s Doctorate is in endocrinology, and she writes widely on menopause. In this blog they explore the effects of peri/menopause specific to a history of childhood sexual abuse (CSA).
