Original Article

Sexual Abuse History and Pelvic Floor Disorders in Women

Authors: Sara B. Cichowski, MD, Gena C. Dunivan, MD, Yuko M. Komesu, MD, Rebecca G. Rogers, MD

Abstract

Objectives: Sexual abuse rates in the general female population range between 15% and 25%, and sexual abuse is known to have a long-term impact on a woman’s health. The aim of this study was to report the prevalence of sexual abuse history in women presenting to clinicians for pelvic floor disorders (PFD) and to determine whether a history of sexual abuse is associated with a specific type of PFD.

Methods: We conducted a retrospective chart review of new urogynecology patients seen at the University of New Mexico Hospital. All women underwent a standardized history and physical examination and completed symptom severity and quality-of-life measures. Univariate and multivariable analyses were conducted to determine which PFDs were associated with a history of sexual abuse among women with and without a history of sexual abuse.

Results: A total of 1899 new urogynecology patients with complete information were identified from January 2007 and October 2011; 1260 (66%) were asked about a history of sexual abuse. The prevalence of sexual abuse was 213/1260 (17%). In the multivariable analysis, only chronic pelvic pain remained significantly associated with a history of sexual abuse.

Conclusions: A history of sexual abuse is common among women with PFDs, and these women were more likely to have chronic pelvic pain.

This content is limited to qualifying members.

Existing members, please login first

If you have an existing account please login now to access this article or view purchase options.

Purchase only this article ($25)

Create a free account, then purchase this article to download or access it online for 24 hours.

Purchase an SMJ online subscription ($75)

Create a free account, then purchase a subscription to get complete access to all articles for a full year.

Purchase a membership plan (fees vary)

Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.

References

1. Mouilso ER, Fischer S, Calhoun KS. A prospective study of sexual assault and alcohol use among first-year college women. Violence Vict. 2012; 27: 78–94.
 
2. Reinhard MJ. The Long Term Neuropsychiatric Effects of Early Trauma. Malibu, CA: Pepperdine University; 2004.
 
3. Koloski NA, Talley NJ, Boyce PM. A history of abuse in community subjects with irritable bowel syndrome and functional dyspepsia: the role of other psychosocial variables. Digestion. 2005; 72: 86–96.
 
4. Molnar BE, Buka SL, Kessler RC. Child sexual abuse and subsequent psychopathology: results from the National Comorbidity Survey. Am J Public Health. 2001; 91: 753–760.
 
5. Talley NJ, Fett SL, Zinsmeister AR, et al. Gastrointestinal tract symptoms and self-reported abuse: a population-based study. Gastroenterology. 1994; 107: 140–149.
 
6. Hilden M, Schei B, Swahnberg K, et al. A history of sexual abuse and health: a Nordic multicenter study. BJOG. 2004; 111: 1121–1127.
 
7. Golding JM, Wilsnack SC, Learman LA. Prevalence of sexual assault history among women with common gynecological symptoms. Am J Obstet Gynecol. 1998; 179: 1013–1019.
 
8. Davila GW, Bernier F, Franco J, et al. Bladder dysfunction in sexual abuse survivors. J Urol. 2003; 170: 476–479.
 
9. Jundt K, Scheer I, Schiessl B, et al. Physical and sexual abuse in patients with overactive bladder: is there an association? Int Urogynecol J Pelvic Floor Dysfunct. 2007; 18: 449–453.
 
10. Peters KM, Carrico DJ, Ibrahim IA, et al. Characterization of clinical cohort of 87 women with interstitial cystitis/painful bladder syndrome. Urology. 2008; 71: 634–640.
 
11. Beck JJ, Elzevier HW, Pelger RC, et al. Multiple pelvic floor complaints are correlated with sexual abuse history. J Sex Med. 2009; 6: 193–198.
 
12. Walker E, Katon W, Harrop-Griffiths J, et al. Relationship of chronic pelvic pain to psychiatric diagnoses and childhood sexual abuse. Am J Psychiatry. 1988; 145: 75–80.
 
13. Rapkin AJ, Kames LD, Darke LL, et al. History of physical and sexual abuse in women with chronic pelvic pain. Obstet Gynecol. 1990; 76: 92–96.
 
14. Paras ML, Murad MH, Chen LP, et al. Sexual abuse and lifetime diagnosis of somatic disorders: a systematic review and meta-analysis. JAMA. 2009; 302: 550–561.
 
15. Peters K, Kalinowksi SE, Carrico DJ, et al. Fact or fiction—is abuse prevalent in patients with interstitial cystitis? Results from a community survey and clinic population. J Urol. 2007; 178: 891–895.
 
16. Friedman MS, Marshal MP, Guadamuz TE, et al. A meta-analysis of disparities in childhood sexual abuse, parental physical abuse, and peer victimization among sexual minority and sexual nonminority individuals. Am J Public Health. 2011; 101: 1481–1494.
 
17. Imhoff LR, Liwanag L, Varma M. Exacerbation of symptom severity of pelvic floor disorders in women who report a history of sexual abuse. Arch Surg. 2012; 147: 1123–1129.