Psychological and physiological aspects of menopause in women with SCI (Collaborative)

PI: C. A. Brooks, MSHA
Funded by:National Institute on Disability and Rehabilitation Research
Grant Number: H133G040274
Dates: 2004-2008
Contact: Melissa Sendroy Terrill msendroy@craighospital.org 303 789 8307

With advances in health care, women with physical disabilities are living longer than previous generations and are making the transition through menopause in greater numbers than ever before. Of the 30 million women with physical disabilities in the United States, more than half are over the age of 50 years constituting a large and growing population. Much of what is known about menopause has been learned from studies of non-disabled women. However, women with disabilities, particularly those with mobility impairments, face elevated risks for co-morbid health conditions and possibly exacerbation of secondary conditions in menopause. Despite these elevated risks, little is known about the moderating effect of physical disability on the relationship between menopause and health.

Women who sustain SCI in young adulthood or early middle age can expect to live a number of years after menopause. Because of gender disparities in injury rates, the majority of studies in the SCI literature use all male or predominantly male samples and from these findings aging with SCI has been conceptualized. However, such studies cannot account for the influence of factors unique to women in their reproductive life cycle, such as menstruation, childbearing and menopause. Women with SCI face a number of health risks associated with the endocrinological and physiological changes of menopause. These include thermodysregulation and vasomotor instability, reduced collagen content and vascular profusion in the skin, bone loss and increased risk of co-morbid health conditions such as obesity and cardiovascular disease (CVD). In addition to these risks, women aging with SCI have noted increased stress related to functional loss and changes in primary relationships and worsening of mood in middle age. At the health-care level, women with SCI face multiple barriers to accessing routine gynecologic health care which is compounded by a lack of knowledge in health care providers about managing the symptoms and risks associated with menopause.

Purpose: This research will investigate the psychological, physical and behavioral aspects of menopause in women who have sustained spinal cord injury (SCI).

The primary purpose of this study is twofold:

to determine if menopause symptoms can be reliably distinguished from the direct effects of SCI and associated secondary conditions and
to investigate whether SCI moderates the relationship of menopause and physical and behavioral outcomes.