Abstract
Purpose of Review
The purpose of this review is to provide readers with an overview of research on reproductive aging among sexual minority women (SMW; women who do not identify as exclusively heterosexual, and report same-sex sexual behaviors or same-sex attraction).
Recent Findings
SMW report health behaviors and risk profiles suggesting they may experience earlier onset of menopause and more severe menopause-related symptoms than heterosexual women. SMW may also have unique forms of resilience related to their sexual orientation that buffer the social-psychological stressors associated with menopause.
Summary
No systematic studies of sexual orientation–related disparities in menopause or its associated symptoms exist. More research is needed to understand the SMW’s unique forms of stress and coping mechanisms related to menopause.
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References
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Greendale GA, Lee NP, Arriola ER. The menopause. Lancet. 1999;353(9152):571–80. https://doi.org/10.1016/S0140-6736(98)05352-5.
Soares CN, Maki PM. Menopausal transition, mood, and cognition: an integrated view to close the gaps. Menopause. 2010;17(4):812–4. https://doi.org/10.1097/gme.0b013e3181de0943.
Vanwesenbeeck I, Vennix P, van de Wiel H. ‘Menopausal symptoms’: associations with menopausal status and psychosocial factors. 2001;22(3):149–58. https://doi.org/10.3109/01674820109049967.
Dillaway HE. (Un) Changing menopausal bodies: how women think and act in the face of a reproductive transition and gendered beauty ideals. Sex Roles. 2005;53(1-2):1–17. https://doi.org/10.1007/s11199-005-4269-6.
Everett B, Sanders J, Myers K, Geist C, Turok D. 1 in 3: challenging heteronormative assumptions in family planning clinics. Contraception. 2017;96(4):298. https://doi.org/10.1016/j.contraception.2017.07.133.
Mojola SA, Everett B. STD and HIV risk factors among U.S. young adults: variations by gender, race, ethnicity and sexual orientation. Perspect Sex Reprod Health. 2012;44(2):125–33. https://doi.org/10.1363/4412512.
Katz-Wise SL, Hyde JS. Victimization experiences of lesbian, gay, and bisexual individuals: a meta-analysis. J Sex Res. 2012;49(2-3):142–67. https://doi.org/10.1080/00224499.2011.637247.
Austin SB, Nelson LA, Birkett MA, Calzo JP, Everett B. Eating disorder symptoms and obesity at the intersections of gender, ethnicity, and sexual orientation in US high school students. Am J Public Health. 2013;103(2):e16–22. https://doi.org/10.2105/AJPH.2012.301150.
Hughes T. Alcohol use and alcohol-related problems among sexual minority women. Alcohol Treat Q. 2011;29(4):403–35. https://doi.org/10.1080/07347324.2011.608336.
Nolen-Hoeksema S, Hilt L. Possible contributors to the gender differences in alcohol use and problems. J Gen Psychol. 2006;133(4):357–74. https://doi.org/10.3200/GENP.133.4.357-374.
Hinchliff S, Gott M, Ingleton C. Sex, Menopause and social context a qualitative study with heterosexual women. J Health Psychol. 2010;15(5):724–33. https://doi.org/10.1177/1359105310368187.
Rieger G, Savin-Williams RC. Gender nonconformity, sexual orientation, and psychological well-being. Arch Sex Behav. 2012;41(3):611–21. https://doi.org/10.1007/s10508-011-9738-0.
Avis NE, Assmann SF, Kravitz HM, Ganz PA, Ory M. quality of life in diverse groups of midlife women: assessing the influence of menopause, health status and psychosocial and demographic factors. Qual Life Res. 2004;13(5):933–46. https://doi.org/10.1023/B:QURE.0000025582.91310.9f.
• Namazi M, Sadeghi R, Behboodi MZ. Social determinants of health in menopause: an integrative review. Int J Women's Health. 2019;11:637–47. https://doi.org/10.2147/IJWH.S228594This review highlights the relationship between social determinants of health and menopause in order to attract the attention of researchers and health care providers.
Meyer IH, Frost DM. Minority stress and the health of sexual minorities. Handb Psychol Sex Orient. 2013:252–66. https://doi.org/10.1093/acprof:oso/9780199765218.003.0018.
Gallicchio L, Miller SR, Kiefer J, Greene T, Zacur HA, Flaws JA. Risk factors for hot flashes among women undergoing the menopausal transition: baseline results from the Midlife Women’s Health Study. Menopause. 2015;22(10):1098–107. https://doi.org/10.1097/GME.0000000000000434.
Ziv-Gal A, Smith RL, Gallicchio L, Miller SR, Zacur HA, Flaws JA. The Midlife Women’s Health Study – a study protocol of a longitudinal prospective study on predictors of menopausal hot flashes. Women’s Midlife Health. 2017;3(1):4. https://doi.org/10.1186/s40695-017-0024-8.
Caceres BA, Makarem N, Hickey KT, Hughes TL. cardiovascular disease disparities in sexual minority adults: an examination of the Behavioral Risk Factor Surveillance System (2014-2016). Am J Health Promot. 2019;33(4):576–85. https://doi.org/10.1177/0890117118810246.
Evans-Polce RJ, Kcomt L, Veliz PT, Boyd CJ, McCabe SE. Alcohol, tobacco, and comorbid psychiatric disorders and associations with sexual identity and stress-related correlates. AJP. 2020;177(11):1073–81. https://doi.org/10.1176/appi.ajp.2020.20010005.
Nystedt T, Rosvall M, Lindström M. Sexual orientation, suicide ideation and suicide attempt: a population-based study. Psychiatry Res. 2019;275:359–65. https://doi.org/10.1016/j.psychres.2019.04.007.
Fernández-Alonso AM, Cuadros J. l, Chedraui P, Mendoza M, Cuadros ÁM, Pérez-López FR. Obesity is related to increased menopausal symptoms among Spanish women. Menopause Int. 2010;16(3):105–10. https://doi.org/10.1258/mi.2010.010029.
Al-Safi ZA, Polotsky AJ. Obesity and menopause. Best Pract Res Clin Obstet Gynaecol. 2015;29(4):548–53. https://doi.org/10.1016/j.bpobgyn.2014.12.002.
Blümel JE, Fica J, Chedraui P, Mezones-Holguín E, Zuñiga MC, Witis S, et al. Sedentary lifestyle in middle-aged women is associated with severe menopausal symptoms and obesity. Menopause. 2016;23(5):488–93. https://doi.org/10.1097/GME.0000000000000575.
Dąbrowska-Galas M, Dąbrowska J, Ptaszkowski K, Plinta R. High physical activity level may reduce menopausal symptoms. Medicina. 2019;55(8):466. https://doi.org/10.3390/medicina55080466.
Eliason MJ, Ingraham N, Fogel SC, McElroy JA, Lorvick J, Mauery DR, et al. A systematic review of the literature on weight in sexual minority women. Womens Health Issues. 2015;25(2):162–75. https://doi.org/10.1016/j.whi.2014.12.001.
Mereish EH, Poteat VP. Let’s get physical: sexual orientation disparities in physical activity, sports involvement, and obesity among a population-based sample of adolescents. Am J Public Health. 2015;105(9):1842–8. https://doi.org/10.2105/AJPH.2015.302682.
Herrick SSC, Duncan LR. A systematic scoping review of engagement in physical activity among LGBTQ+ adults. J Phys Act Health. 2018;15(3):226–32. https://doi.org/10.1123/jpah.2017-0292.
Soares C. Depression and menopause: current knowledge and clinical recommendations for a critical window. Psychiatr Clin North Am. 2017;40(2):239–54. https://doi.org/10.1016/j.psc.2017.01.007.
Bremer E, Jallo N, Rodgers B, Kinser P, Dautovich N. Anxiety in menopause: a distinctly different syndrome? J Nurse Pract. 2019;15(5):374–8. https://doi.org/10.1016/j.nurpra.2019.01.018.
Moudi A, Dashtgard A, Salehiniya H, Sadat Katebi M, Reza Razmara M, Reza JM. The relationship between health-promoting lifestyle and sleep quality in postmenopausal women. Biomedicine (Taipei). 2018;8(2). https://doi.org/10.1051/bmdcn/2018080211.
Worsley R, Bell RJ, Gartoulla P, Robinson PJ, Davis SR. Moderate–severe vasomotor symptoms are associated with moderate–severe depressive symptoms. J Women's Health. 2017;26(7):712–8. https://doi.org/10.1089/jwh.2016.6142.
Milic J, Glisic M, Voortman T, Borba LP, Asllanaj E, Rojas LZ, et al. Menopause, ageing, and alcohol use disorders in women. Maturitas. 2018;111:100–9. https://doi.org/10.1016/j.maturitas.2018.03.006.
Huang C-H, Li C-L, Kor C-T, Chang C-C. Menopausal symptoms and risk of coronary heart disease in middle-aged women: a nationwide population-based cohort study. PLoS One. 2018;13(10):e0206036. https://doi.org/10.1371/journal.pone.0206036.
Pérez JAM, Palacios S, Chavida F, Pérez M. Severity of menopausal symptoms and cardiovascular and osteoporosis risk factors. Climacteric. 2013;16(2):226–34. https://doi.org/10.3109/13697137.2012.688077.
Mulhall S, Andel R, Anstey KJ. Variation in symptoms of depression and anxiety in midlife women by menopausal status. Maturitas. 2018;108:7–12. https://doi.org/10.1016/j.maturitas.2017.11.005.
Nateri NS, Beigi M, Kazemi A, Shirinkam F. Women coping strategies towards menopause and its relationship with sexual dysfunction. Iran J Nurs Midwifery Res. 2017;22(5):343–7. https://doi.org/10.4103/ijnmr.IJNMR_234_15.
Ayers B, Forshaw M, Hunter MS. The impact of attitudes towards the menopause on women’s symptom experience: a systematic review. Maturitas. 2010;65(1):28–36. https://doi.org/10.1016/j.maturitas.2009.10.016.
Hyde A, Nee J, Howlett E, Butler M, Drennan J. The ending of menstruation: perspectives and experiences of lesbian and heterosexual women. J Women Aging. 2011;23(2):160–76. https://doi.org/10.1080/08952841.2011.561145.
Howell LC, Beth A. Pioneers in our own lives: grounded theory of lesbians’ midlife development. J Women Aging. 2004;16(3-4):133–47. https://doi.org/10.1300/J074v16n03_10.
Schope RD Who’s afraid of growing old? Gay and lesbian perceptions of aging. J Gerontol Soc Work. 2005;45(4):23–39. https://doi.org/10.1300/J083v45n04_03.
Thompson KA, Bardone-Cone AM. Evaluating attitudes about aging and body comparison as moderators of the relationship between menopausal status and disordered eating and body image concerns among middle-aged women. Maturitas. 2019;124:25–31. https://doi.org/10.1016/j.maturitas.2019.03.014.
Rubinstein HR, Foster JL. ‘I don’t know whether it is to do with age or to do with hormones and whether it is do with a stage in your life’: making sense of menopause and the body. J Health Psychol. 2013;18(2):292–307. https://doi.org/10.1177/1359105312454040.
Share TL, Mintz LB. Differences between lesbians and heterosexual women in disordered eating and related attitudes. J Homosex. 2002;42(4):89–106. https://doi.org/10.1300/J082v42n04_06.
Steele SM, Belvy L, Veldhuis CB, Martin K, Nisi R, Hughes TL. Femininity, masculinity, and body image in a community-based sample of lesbian and bisexual women. Women Health. 2019;59:1–16. https://doi.org/10.1080/03630242.2019.1567645.
Dąbrowska-Galas M, Dąbrowska J, Michalski B. Sexual dysfunction in menopausal women. Sex Med. 2019;7(4):472–9. https://doi.org/10.1016/j.esxm.2019.06.010.
Ussher JM, Perz J, Parton C. Sex and the menopausal woman: a critical review and analysis. Fem Psychol. 2015;25(4):449–68. https://doi.org/10.1177/0959353515579735.
Erbil N. Attitudes towards menopause and depression, body image of women during menopause. Alex J Med. 2018;54(3):241–6. https://doi.org/10.4314/bafm.v54i3.
Kanadys K, Wiktor-Stona A, Lewicka M, et al. Predictors of the quality of life of women in peri-menopausal period. Ann Agric Environ Med. 2016;23(4). https://doi.org/10.5604/12321966.1226860.
•• Paine EA, Umberson D, Reczek C. Sex in midlife: women’s sexual experiences in lesbian and straight marriages. J Marriage Fam. 2019;81(1):7–23. https://doi.org/10.1111/jomf.12508This article is one of the only to address differences in sexual experiences and attitudes toward menopause between straight and lesbian marriages.
Heywood W, Minichiello V, Lyons A, et al. The impact of experiences of ageism on sexual activity and interest in later life. Ageing Soc. 2017;39(4):795–814. https://doi.org/10.1017/S0144686X17001222.
• Brennan-Ing M, Kaufman JE, Larson B, Gamarel KE, Seidel L, Karpiak SE. Sexual health among lesbian, gay, bisexual, and heterosexual older adults: an exploratory analysis. Clin Gerontol. 2020;0(0):1-13. https://doi.org/10.1080/07317115.2020.1846103. This article explores sexual activity of older adults across sexual orientations. It uniquely focuses on older adults and argues for further research on older sexual minority sexual health.
Cohen JN, Byers ES. Beyond lesbian bed death: enhancing our understanding of the sexuality of sexual-minority women in relationships. J Sex Res. 2014;51(8):893–903. https://doi.org/10.1080/00224499.2013.795924.
Wariso BA, Guerrieri GM, Thompson K, Koziol DE, Haq N, Martinez PE, et al. Depression during the menopause transition: impact on quality of life, social adjustment, and disability. Arch Womens Ment Health. 2017;20(2):273–82. https://doi.org/10.1007/s00737-016-0701-x.
Duffy O, Iversen L, Hannaford PC. The menopause ‘It’s somewhere between a taboo and a joke’. A focus group study. Climacteric. 2011;14(4):497–505. https://doi.org/10.3109/13697137.2010.549974.
Winterich JA. Sex, menopause, and culture sexual orientation and the meaning of menopause for women’s sex lives. Gend Soc. 2003;17(4):627–42. https://doi.org/10.1177/0891243203253962.
Rodolpho JRC, Quirino BC, Hoga LAK, Rosa PLFS. Men’s perceptions and attitudes toward their wives experiencing menopause. J Women Aging. 2016;28(4):322–33. https://doi.org/10.1080/08952841.2015.1017430.
Vegunta S, Kuhle C, Kling JM, Files JA, Kapoor E, David PS, et al. The association between recent abuse and menopausal symptom bother: results from the Data Registry on Experiences of Aging, Menopause, and Sexuality (DREAMS). Menopause. 2016;23(5):494–8. https://doi.org/10.1097/GME.0000000000000578.
Messinger AM. Invisible victims: same-sex IPV in the National Violence Against Women Survey. J Interpersonal Violence. 2011;26(11):2228–43. https://doi.org/10.1177/0886260510383023.
Hayfield N, Clarke V, Halliwell E. Bisexual women’s understandings of social marginalisation: ‘The heterosexuals don’t understand us but nor do the lesbians’. Fem Psychol. 2014;24(3):352–72. https://doi.org/10.1177/0959353514539651.
Understanding the status and well being of sexual and gender diverse populations | national academies. 2020. https://www.nationalacademies.org/our-work/understanding-the-status-and-well-being-of-sexual-and-gender-diverse-populations
Boehmer U, Timm A, Ozonoff A, Potter J. Applying the female sexual functioning index to sexual minority women. J Women's Health. 2011;21(4):401–9. https://doi.org/10.1089/jwh.2011.3072.
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Everett, B.G., Jenkins, V. & Hughes, T.L. Reproductive Aging Among Sexual Minority Women. Curr Obstet Gynecol Rep 10, 31–37 (2021). https://doi.org/10.1007/s13669-021-00306-3
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DOI: https://doi.org/10.1007/s13669-021-00306-3