{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T23:40:31Z","timestamp":1790811631596,"version":"4.1.0"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2023,4,27]],"date-time":"2023-04-27T00:00:00Z","timestamp":1682553600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,5,26]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>One in 3 children has had at least 1 adverse childhood experience (ACE), and ACEs have been associated with multiple medical and psychiatric morbidities in women later in life, including greater menopause symptom burden.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To evaluate the association between ACEs and female sexual dysfunction (FSD) in midlife women.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross-sectional analysis from DREAMS\u2014the Data Registry on Experiences of Aging, Menopause, and Sexuality\u2014was conducted with questionnaires completed by women aged 40 to 65\u00a0years who presented to a women\u2019s health clinic at Mayo Clinic in Rochester, Minnesota, from May 2015 to December 2016. History of ACEs was obtained with the validated ACE questionnaire. FSD was assessed by the Female Sexual Function Index and the Female Sexual Distress Scale\u2013Revised.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcomes<\/jats:title>\n                    <jats:p>The association between ACEs and FSD (defined as Female Sexual Function Index score \u226426.55 and Female Sexual Distress Scale\u2013Revised score\u2009\u226511) was evaluated via a multivariable logistic regression model, adjusting for age, menopause status, hormone therapy use, anxiety, depression, relationship satisfaction, hot flash severity, and history of abuse in the past year.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Women (N\u2009=\u20091572) had a mean age of 53.2\u00a0years. Overall 59% reported having at least 1 ACE. When compared with no ACEs, a history of \u22654 ACEs significantly increased the odds of not being sexually active (odds ratio, 1.83; 95% CI, 1.30-2.57; P\u2009&amp;lt;\u2009.001). Among sexually active women, the proportion of women with FSD increased sequentially as the number of ACEs increased. In the univariate analysis, a history of \u22654 ACEs significantly increased the odds of FSD as compared with no ACEs (odds ratio, 2.12; 95% CI, 1.50-2.99; P\u2009&amp;lt;\u2009.001). The association remained statistically significant in the multivariable analysis after adjusting for confounders (odds ratio, 1.75; 95% CI, 1.15-2.68; P\u2009=\u2009.009).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Implications<\/jats:title>\n                    <jats:p>The findings highlight an opportunity for clinicians to screen for ACEs in women with sexual dysfunction and offer appropriate treatment and counseling as indicated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Strengths and Limitations<\/jats:title>\n                    <jats:p>Strengths of the study include the large cohort, the use of validated tools for assessment of ACEs and FSD, and the adjustment for multiple potential confounding factors. Limitations include the cross-sectional study design, recall bias in reporting ACEs and recent abuse, and the low representation of racially and ethnically diverse women in the cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The study demonstrates an increased risk of sexual inactivity and sexual dysfunction in midlife women who experienced childhood adversity. The sexual dysfunction in women with ACEs seems to be independent of other factors that potentially affect female sexual function in midlife.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jsxmed\/qdad053","type":"journal-article","created":{"date-parts":[[2023,4,27]],"date-time":"2023-04-27T22:59:25Z","timestamp":1682636365000},"page":"792-799","source":"Crossref","is-referenced-by-count":11,"title":["Adverse childhood experiences and sexual dysfunction in midlife women: Is there a link?"],"prefix":"10.1093","volume":"20","author":[{"given":"Mariam","family":"Saadedine","sequence":"first","affiliation":[{"name":"Division of General Internal Medicine, Mayo Clinic, Jacksonville , FL 32224 , United States"},{"name":"Mayo Clinic Women\u2019s Health , Rochester, MN 55902 , United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Faubion","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine , Mayo Clinic, Jacksonville, FL 32224 , United States"},{"name":"Mayo Clinic Women\u2019s Health , Rochester, MN 55902 , United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheryl","family":"Kingsberg","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University Hospitals Cleveland Medical Center , Cleveland, OH 44106 , United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felicity","family":"Enders","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences , Mayo Clinic, Rochester, MN 55902 , United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol","family":"Kuhle","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences, Mayo Clinic , Rochester, MN 55902 , United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliana M","family":"Kling","sequence":"additional","affiliation":[{"name":"Mayo Clinic Women\u2019s Health , Rochester, MN 55902 , United States"},{"name":"Division of Women\u2019s Health Internal Medicine, Mayo Clinic , Scottsdale, AZ 85260 , United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin","family":"Mara","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences, Mayo Clinic , Rochester, MN 55902 , United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ekta","family":"Kapoor","sequence":"additional","affiliation":[{"name":"Mayo Clinic Women\u2019s Health , Rochester, MN 55902 , United States"},{"name":"Division of General Internal Medicine , Mayo Clinic, Rochester, MN 55902 , United States"},{"name":"Division of Endocrinology, Diabetes, Metabolism, and Nutrition , Mayo Clinic, Rochester, MN 55902 , United States"},{"name":"Women\u2019s Health Research Center , Mayo Clinic, Rochester, MN 55902 , United States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,4,27]]},"reference":[{"key":"2023053112003418100_ref1","year":"2020"},{"issue":"1","key":"2023053112003418100_ref2","doi-asserted-by":"crossref","first-page":"1327","DOI":"10.1186\/s12889-020-09411-z","article-title":"The frequencies and disparities of adverse childhood experiences in the US","volume":"20","author":"Giano","year":"2020","journal-title":"BMC Public Health"},{"issue":"1","key":"2023053112003418100_ref3","doi-asserted-by":"crossref","first-page":"1708618","DOI":"10.1080\/20008198.2019.1708618","article-title":"Females have more complex patterns of childhood adversity: implications for mental, social, and emotional outcomes in adulthood","volume":"11","author":"Haahr-Pedersen","year":"2020","journal-title":"Eur J Psychotraumatol"},{"issue":"12","key":"2023053112003418100_ref4","doi-asserted-by":"crossref","first-page":"1269","DOI":"10.1001\/jamapediatrics.2021.2320","article-title":"Association of childhood adversity with morbidity and mortality in US adults: a systematic review","volume":"175","author":"Grummitt","year":"2021","journal-title":"JAMA Pediatr"},{"key":"2023053112003418100_ref5","doi-asserted-by":"crossref","DOI":"10.7554\/eLife.71770","article-title":"Adverse childhood experiences and resilience among adult women: a population-based study","volume":"11","author":"Dan\u00edelsd\u00f3ttir","year":"2022","journal-title":"elife"},{"issue":"12","key":"2023053112003418100_ref6","doi-asserted-by":"crossref","first-page":"3243","DOI":"10.1007\/s11136-018-1937-x","article-title":"Child maltreatment as a social determinant of midlife health-related quality of life in women: do psychosocial factors explain this association?","volume":"27","author":"Lin","year":"2018","journal-title":"Qual Life Res"},{"key":"2023053112003418100_ref7","doi-asserted-by":"crossref","first-page":"104418","DOI":"10.1016\/j.chiabu.2020.104418","article-title":"Impact of adverse childhood experiences on quality-adjusted life expectancy in the US population","volume":"102","author":"Jia","year":"2020","journal-title":"Child Abuse Negl"},{"issue":"1","key":"2023053112003418100_ref8","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1097\/gme.0b013e31805fea75","article-title":"Childhood abuse or neglect is associated with increased vasomotor symptom reporting among midlife women","volume":"15","author":"Thurston","year":"2008","journal-title":"Menopause"},{"key":"2023053112003418100_ref9","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1016\/j.maturitas.2020.10.006","article-title":"Association of adverse childhood experiences with menopausal symptoms: results from the Data Registry on Experiences of Aging, Menopause and Sexuality (DREAMS)","volume":"143","author":"Kapoor","year":"2021","journal-title":"Maturitas"},{"issue":"5","key":"2023053112003418100_ref10","doi-asserted-by":"crossref","first-page":"970","DOI":"10.1097\/AOG.0b013e3181898cdb","article-title":"Sexual problems and distress in United States women: prevalence and correlates","volume":"112","author":"Shifren","year":"2008","journal-title":"Obstet Gynecol"},{"issue":"3","key":"2023053112003418100_ref11","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1002\/jts.21923","article-title":"Assessing the association between childhood sexual abuse and adult sexual experiences in women with sexual difficulties","volume":"27","author":"Stephenson","year":"2014","journal-title":"J Trauma Stress"},{"issue":"3","key":"2023053112003418100_ref12","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1080\/00224499.2016.1158229","article-title":"A dyadic perspective on childhood maltreatment for women with provoked vestibulodynia and their partners: associations with pain and sexual and psychosocial functioning","volume":"54","author":"Corsini-Munt","year":"2017","journal-title":"J Sex Res"},{"key":"2023053112003418100_ref13","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1016\/j.maturitas.2017.09.013","article-title":"Data Registry on Experiences of Aging, Menopause, and Sexuality (DREAMS): a cohort profile","volume":"107","author":"Faubion","year":"2018","journal-title":"Maturitas"},{"issue":"4","key":"2023053112003418100_ref14","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1016\/S0749-3797(98)00017-8","article-title":"Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: the Adverse Childhood Experiences (ACE) Study","volume":"14","author":"Felitti","year":"1998","journal-title":"Am J Prev Med"},{"issue":"1","key":"2023053112003418100_ref15","doi-asserted-by":"crossref","first-page":"1581447","DOI":"10.1080\/2331205X.2019.1581447","article-title":"The Adverse Childhood Experiences Questionnaire: two decades of research on childhood trauma as a primary cause of adult mental illness, addiction, and medical diseases","volume":"6","author":"Zarse","year":"2019","journal-title":"Cogent Medicine"},{"key":"2023053112003418100_ref16","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1016\/B978-0-12-384978-6.00023-6","volume-title":"Women and Health","author":"Goldfarb","year":"2013","edition":"2nd"},{"issue":"2","key":"2023053112003418100_ref17","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1111\/j.1743-6109.2007.00672.x","article-title":"Validation of the Female Sexual Distress Scale\u2013Revised for assessing distress in women with hypoactive sexual desire disorder","volume":"5","author":"Derogatis","year":"2008","journal-title":"J Sex Med"},{"issue":"9","key":"2023053112003418100_ref18","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1046\/j.1525-1497.2001.016009606.x","article-title":"The PHQ-9","volume":"16","author":"Kroenke","year":"2001","journal-title":"J Gen Intern Med"},{"issue":"3","key":"2023053112003418100_ref19","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1097\/MLR.0b013e318160d093","article-title":"Validation and standardization of the Generalized Anxiety Disorder screener (GAD-7) in the general population","volume":"46","author":"L\u00f6we","year":"2008","journal-title":"Med Care"},{"issue":"2","key":"2023053112003418100_ref20","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1016\/j.mefs.2017.10.005","article-title":"Reliability and validity of the Kansas Marital Satisfaction Scale (KMSS) in infertile people","volume":"23","author":"Omani-Samani","year":"2018","journal-title":"Middle East Fertility Society Journal"},{"key":"2023053112003418100_ref21","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1186\/1477-7525-2-45","article-title":"The Menopause Rating Scale (MRS) scale: a methodological review","volume":"2","author":"Heinemann","year":"2004","journal-title":"Health Qual Life Outcomes"},{"issue":"1","key":"2023053112003418100_ref22","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1186\/s12905-018-0602-4","article-title":"Predictors of female sexual dysfunction: a systematic review and qualitative analysis through gender inequality paradigms","volume":"18","author":"McCool-Myers","year":"2018","journal-title":"BMC Womens Health"},{"issue":"2","key":"2023053112003418100_ref23","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1080\/13697137.2021.1915270","article-title":"Depression in midlife women attending a menopause clinic is associated with a history of childhood maltreatment","volume":"25","author":"Shea","year":"2022","journal-title":"Climacteric"},{"key":"2023053112003418100_ref24","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1016\/j.bodyim.2022.01.003","article-title":"Adverse childhood experiences and body dysmorphic symptoms: a meta-analysis","volume":"40","author":"Longobardi","year":"2022","journal-title":"Body Image"},{"issue":"8","key":"2023053112003418100_ref25","doi-asserted-by":"crossref","DOI":"10.1093\/sleep\/zsz108","article-title":"Traumatic childhood experiences and multiple dimensions of poor sleep among adult women","volume":"42","author":"McWhorter","year":"2019","journal-title":"Sleep"},{"issue":"1","key":"2023053112003418100_ref26","doi-asserted-by":"crossref","first-page":"e208","DOI":"10.1097\/SPV.0000000000000894","article-title":"Adverse childhood experiences in women with overactive bladder or interstitial cystitis\/bladder pain syndrome","volume":"27","author":"Komesu","year":"2021","journal-title":"Female Pelvic Med Reconstr Surg"},{"issue":"4","key":"2023053112003418100_ref27","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1080\/0092623X.2016.1176609","article-title":"Cumulative childhood trauma and adult sexual satisfaction: mediation by affect dysregulation and sexual anxiety in men and women","volume":"43","author":"Bigras","year":"2017","journal-title":"J Sex Marital Ther"},{"issue":"3","key":"2023053112003418100_ref28","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1016\/j.jsxm.2017.01.013","article-title":"Cumulative adverse childhood experiences and sexual satisfaction in sex therapy patients: what role for symptom complexity?","volume":"14","author":"Bigras","year":"2017","journal-title":"J Sex Med"},{"issue":"1","key":"2023053112003418100_ref29","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1080\/0092623X.2019.1626309","article-title":"Childhood interpersonal trauma and sexual satisfaction in patients seeing sex therapy: examining mindfulness and psychological distress as mediators","volume":"46","author":"Godbout","year":"2020","journal-title":"J Sex Marital Ther"},{"issue":"8","key":"2023053112003418100_ref30","doi-asserted-by":"crossref","first-page":"913","DOI":"10.1080\/07448481.2020.1715413","article-title":"Adverse childhood experiences and interpersonal violence among college students: does a relationship exist?","volume":"69","author":"Cprek","year":"2021","journal-title":"J Am Coll Heal"},{"issue":"12","key":"2023053112003418100_ref31","doi-asserted-by":"crossref","first-page":"832","DOI":"10.1016\/j.annepidem.2012.09.008","article-title":"Adverse childhood experiences and intimate partner violence: testing psychosocial mediational pathways among couples","volume":"22","author":"Mair","year":"2012","journal-title":"Ann Epidemiol"}],"container-title":["The Journal of Sexual Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jsm\/article-pdf\/20\/6\/792\/50461379\/qdad053.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jsm\/article-pdf\/20\/6\/792\/50461379\/qdad053.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,31]],"date-time":"2023-05-31T08:01:08Z","timestamp":1685520068000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jsm\/article\/20\/6\/792\/7146045"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,27]]},"references-count":31,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2023,4,27]]},"published-print":{"date-parts":[[2023,5,26]]}},"URL":"https:\/\/doi.org\/10.1093\/jsxmed\/qdad053","relation":{},"ISSN":["1743-6095","1743-6109"],"issn-type":[{"value":"1743-6095","type":"print"},{"value":"1743-6109","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,6]]},"published":{"date-parts":[[2023,4,27]]}}}