Menopause experience among people with criminal legal system involvement

Abstract

OBJECTIVE: We aim to describe menopause symptom burden during and after incarceration for the growing population of women with a history of criminal legal system (CLS) involvement.

METHODS: We used Menopause Rating Scale symptom data from the final year of a multiwave cohort of adult women with a history of CLS involvement in three US cities. We also used qualitative semistructured interview data about menopause treatment in the community from adult women from five US states who experienced menopause during their CLS involvement. Descriptive statistics and qualitative thematic analysis were used to triangulate findings.

RESULTS: Of 507 women, 348 (68.8%) reported menstrual cycle data. The mean age was 46. Women were either premenopausal (n=151), early perimenopausal (n=25), late perimenopausal (n=10), or postmenopausal (n=162). Symptoms were common and differed by group. The most severe symptoms in premenopause, early perimenopause, late perimenopause, and postmenopause were joint pain (2.27, SD 1.12), sleep problems (2.44, SD 1.13), joint pain (2.80, SD 0.45), and hot flashes (2.42, SD 1.07), respectively. The qualitative analysis included 29 semistructured interviews focused on access to menopause treatment in the community during or after CLS involvement. Primary themes were logistical barriers (lack of provider, insurance/financial, transportation) and quality of care barriers (poor provider communication skills, lack of provider knowledge).

CONCLUSION: Women with a history of CLS involvement commonly experience menopausal symptoms, some of which are severe. These symptoms are experienced in the context of CLS involvement that may amplify barriers to accessing care.