History of child abuse linked to female sexual dysfunction in midlife

Women with an adverse childhood experience (ACE) are more likely to experience sexual dysfunction (SD) and sexual inactivity in midlife, irrespective of other factors that may influence female sexual function in adulthood, reveals a study.

A cross-sectional analysis from the Data Registry on Experiences of Aging, Menopause, and Sexuality (DREAMS) was performed to examine the association between ACEs and female SD in midlife. Women aged 40‒60 years who presented to Mayo Clinic in Rochester, Minnesota, US, from May 2015 to December 2016 were included.

The investigators obtained ACE history using a validated ACE questionnaire and assessed female SD using the Female Sexual Function Index and the Female Sexual Distress Scale‒Revised. They evaluated the association between ACEs and SD using a multivariable logistic regression model, adjusted for age, menopause status, hormone therapy use, anxiety, depression, relationship satisfaction, hot flash severity, and history of abuse in the past year.

A total of 1,572 women (mean age 53.2 years) were included in the analysis. Of these, 59 percent reported having at least one ACE. A history of at least four ACEs was significantly associated with a greater likelihood of not being sexually active (odds ratio [OR], 1.83, 95 percent confidence interval [CI], 1.30‒2.57; p<0.001) compared with no ACEs.

Among sexually active women, the proportion of those with SD increased sequentially as the number of ACEs increased.

Univariate analysis revealed the association of a history of ≥4 ACEs with a significant increase in the odds of SD relative to no ACEs (OR, 2.12, 95 percent CI, 1.50‒2.99; p<0.001). This association persisted in the multivariable analysis after adjustments for confounders (OR, 1.75, 95 percent CI, 1.15‒2.68; p=0.009).

“The findings highlight an opportunity for clinicians to screen for ACEs in women with SD and offer appropriate treatment and counselling as indicated,” the investigators said.