Editor’s Note: This article was updated to reflect the addition of comments from the study author.

For women in midlife, exposure to sexual harassment and sexual assault is widespread and associated with higher blood pressure (BP, harassment), poorer mental health (assault), and poorer sleep (both), according to a study published in JAMA Internal Medicine.

Rebecca C. Thurston, PhD, a board member of The North American Menopause Society (NAMS), and associates investigated the relationship between history of sexual harassment and sexual assault, and BP, depressed mood, anxiety, and quality of sleep among midlife women.

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A total of 304 nonsmoking women aged 40 to 60 years (mean age, 54 years) with no history of cardiovascular disease (CVD) underwent physical analysis including BP, height, and weight measurement, as well as medical history assessment. A psychosocial questionnaire was included to record workplace sexual harassment, sexual assault, depression, anxiety, and sleep quality. Sexual harassment was identified as experiencing physical or verbal sexual harassment in the workplace, and sexual assault was identified as unwanted sexual contact.

Of the cohort, 19% of women (n=58) reported having experienced sexual harassment at work, and 22% of women (n=67) reported a history of sexual assault.

For women who were not taking antihypertensive medications, the odds of stage 1 or 2 hypertension were significantly greater for sexual harassment (odds ratio [OR], 2.36); odds of clinically poor sleep were also associated with sexual harassment (OR, 1.89).

Sexual assault was significantly associated with greater odds of clinically increased depressive symptoms, anxiety, and poor sleep (OR; 2.86, 2.26, and 2.15, respectively).

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“Future work should consider whether preventing or mitigating sexual harassment and sexual assault can improve women’s mental health and cardiovascular health,” the authors concluded. “Given the high prevalence of sexual harassment and assault, addressing these prevalent and potent social exposure may be critical to promoting health and preventing disease in women.”

In a discussion with The Clinical Advisor, Dr Thurston provided additional insight into her research, which she presented at the 2018 NAMS Annual Meeting.  Although the study focused on middle-aged women, future research should also address the effect of workplace sexual harassment on younger women. In addition, “as the study sample was composed of about a third non-white women, who were principally African American (reflecting the demographics of the Pittsburgh area), and the other two-thirds were white women, I would like to also study Hispanic and Asian women to learn about their experiences,” Dr Thurston commented.  “We as a society are gaining increased awareness of these issues, and the public and policy makers are taking note. This work further underscores not only how common these experiences are, but also their potential long-term implications for women’s health.“


Thurston RC, Chang Y, Matthews KA, von Känel R, Koenen K. Association of sexual harassment and sexual assault with midlife women’s mental and physical health [published October 3, 2018]. JAMA Intern Med. doi:10.1001/jamainternmed.2018.4886