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    Study explores impact of childhood trauma on sexual function in midlife women

Troubled looking middle-aged woman seated in a chair with a man resting a hand on her shoulder.

One out of three children will have at least one stressful or traumatic childhood experience, including things such as their parents divorcing or a family member with a drug or alcohol problem, according to the latest National Survey of Children's Health. In a new study, Mayo Clinic researchers found that such adverse childhood experiences may be linked to sexual inactivity and sexual dysfunction in women later in life. Their findings are published in The Journal of Sexual Medicine.

Researchers recommend care providers screen their patients with sexual dysfunction for adverse childhood experiences and offer multidisciplinary treatment including referral for counseling.

About the study

The researchers studied a group of more than 1,500 middle-aged women (ages 40-65, with an average age of 53) who visited the Menopause and Women's Sexual Health Clinic at Mayo Clinic's campus in Minnesota between 2015 and 2016 for concerns related to menopause and sexual health. The women were asked to complete a survey before their visits, which included questions about any history of adverse childhood experiences, along with sexual function, recent abuse, their mood, anxiety, menopause symptoms and relationship satisfaction.

The information gathered was reported in the Data Registry on Experiences of Aging, Menopause, and Sexuality (DREAMS), a Mayo Clinic women's health registry. The researchers then looked at the association between female sexual dysfunction and adverse childhood experiences — defined in the study as traumatic experiences that happen during childhood and adolescence and entail physical, emotional, or sexual abuse, or growing up in a house with violence, drug use, mental health issues, or insecurity due to parent separation, divorce or incarceration.

What researchers found

They found that women with four or more adverse childhood experiences were nearly twice as likely to be sexually inactive compared to women with no exposure to childhood adversity and were two times more likely to have sexual dysfunction in midlife. The study defines female sexual dysfunction as a disorder involving persistent problems with sexual desire, arousal, lubrication, satisfaction, orgasm and/or sexual pain that is associated with personal distress to the woman experiencing these symptoms.

"This association seemed to be independent of other factors that also affect female sexual function such as age, menopause status, hormone therapy use, anxiety, depression, marital satisfaction and history of recent abuse," says Mariam Saadedine, M.D., a research fellow at Mayo Clinic in Florida and the study's first author.

"This research adds to the literature exploring sexual function in women," says Ekta Kapoor, M.B.B.S., assistant director of the Mayo Clinic Center for Women’s Health and the study's senior author. "Sexual dysfunction has a significant impact on a woman's quality of life. Based on these findings, we encourage healthcare providers to screen for adverse childhood experiences in women with sexual dysfunction and offer multidisciplinary treatment including referral for counseling as needed. If the consequences of childhood adversity are not adequately addressed, other interventions to improve sexual function may not be successful."

The next steps in this research are to evaluate the associations between adverse childhood experiences and female sexual dysfunction in a more diverse group of women, including those of lower socioeconomic status and those with limited access to healthcare.

See the paper for the complete study, list of authors and conflicts of interest.