Say “I Don't”? Marriage Could Hurt Older Women's Health


Postmenopausal women who get married have worse health outcomes in new study.

primary care, family medicine, internal medicine, OBGYN, women’s health, geriatrics, menopause, postmenopausal

Besides getting a king size bed to yourself, there appears to be another upside to being divorced or separated—at least for postmenopausal women. A recent study from the University of Arizona (UA) found totally opposite results from other studies on the same subject.

“Earlier studies on marriage and divorce have shown that marriage is usually associated with a longer lifespan and fewer health problems, while divorce is associated with higher mortality,” lead author, Randa Kutob, MD, MPH, an associate professor of family and community medicine, said in a news release.

The researchers looked at how marital status transition impacted health indicators—body mass index (BMI), blood pressure, and waist circumference—and health behaviors, such as physical activity, smoking, alcohol use, and diet pattern. A total of 79,094 postmenopausal women ages 50 to 79 were followed for three years. Overall, the women were described as relatively healthy and employed. They were categorized into one of three groups:

  • Went from single to married (or self-defined their relationship as marriage-like)
  • Went from married to either separated or divorced
  • Did not have a change in marital status (whether married or unmarried)

A total of 30,108 women were unmarried at the beginning of the study. Of those, 28,572 women stayed unmarried and 1,536 women were married by year three. The 48,986 women who were married (or in a marriage-like relationship) at baseline were split into two groups: those who stayed married (48,316 women) and those who became divorced or separated (670 women). The 2,792 women who became widowed during the three-year study period were excluded from the study.

Two analyses were conducted and data were adjusted for age, race/ethnicity, income, education, social support, emotional well-being, and depression.

Both the single-to-married and married-to-single groups gained weight over the three years. There was also a slight increase in waist circumference, but not a significant difference between the two groups. The women who started the study as single (whether they had been married before or not) and became married had a greater increase in BMI. Kutob, who is also director of the UA College of Medicine’s Office of Continuing Medical Education, explained that this isn’t uncommon given the age population. In fact, marriage-related weight gain has been tied to women of all ages in past studies. One hypothesis is that couples spend more time sitting as well as eating larger meals.

Regardless of the BMI and waist circumference changes, both marital status transition groups of women showed improved dietary quality scores, based on the Alternate Healthy Eating Index (AHEI). However, alcohol intake increased for women who became married and slightly decreased for unmarried women. Both groups had similar decreases in physical activity levels.

Further findings indicated that the women who remained unmarried had a decrease in systolic blood pressure, but women who got married experienced the opposite. Both groups had similar decreases in diastolic blood pressure, but a greater decrease was observed in those who remained unmarried.

Getting married didn’t appear to impact whether women began smoking or stopped smoking. On the other hand, the risk of smoking significantly increased for women who went from married to separated or divorced, however, it didn’t impact smoking cessation.

“The interesting thing we found in our study is that with divorce in postmenopausal women, it’s not all negative, at least not in the short term,” Kutob continued. The results indicate that postmenopausal women are making healthier choices after divorce—which isn’t all that uncommon since some people tend to focus on their well-being following a breakup.

This research certainly isn’t to say that filing for divorce should be a decision based on hopes for betterl health outcomes. But if that’s where life leads, there might be some positives to it.

“As a health provider, my takeaway is that I should be thinking about marital transitions, and when people get married, say congratulations but also give them some advice and tools for their health,” Kutob concluded, “and encourage all women as they age to continue being physically active.”

The study, “Relationship Between Marital Transitions, Health Behaviors, and Health Indicators of Postmenopausal Women: Results from the Women’s Health Initiative,” was published in the Journal of Women’s Health. The news release was provided by UA.

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