By Wendy Maltz LCSW, DST (first appeared in Bottom Line Health, Dec. 2011)
Sexual abuse—be it recent or years ago—is often linked to mental health problems such
as depression and anxiety in the estimated one in four women and one in six men who have been sexually assaulted before the age of 18.
Now:A growing body of evidence now links a history of molestation and/or rape to a wide variety of physicalailments.
Problem:Sexual abuse survivors—and their doctors—often don’t realize that their medical problems may stem from the abuse. What’s more, many people who were sexually abused are reluctant to mention it to their doctors because they feel shame and anxiety about what happened to them.
SEXUAL ABUSE And POOR HEALTH
Sexual abuse and other traumatic experiences have been shown to cause abnormal /unstable levels of the primary stress hormone cortisol, which can persist for years. Chronically elevated levels of cortisol can lead to inflammation, a contributing factor in major illnesses such as chronic fatigue syndrome, type 2 diabetes, arthritis, and even heart disease. Sexual abuse has been identified as a risk factor in asthma, hypertension, unwanted pregnancy, panic attacks, low thyroid, eating disorders, sleep disturbances, breast cancer, herpes, urinary tract infections, self-injury and more. Also, sexual abuse survivors have higher than average rates of drug and alcohol abuse, tobacco use, and risky sexual behavior—all of which can lead to lead a variety of health problems.
Other common physical health effects of sexual abuse…
Obesity.Interpersonal violence in childhood, including sexual abuse, has been found to be a risk factor in adult obesity. Unpleasant emotions, chronic stress, and disordered eating are thought to be involved. Survivors of sexual abuse may also overeat and become overweight as a form of self-soothing and/or a way of discouraging sexual advances.
Headaches.Even years after sexual abuse, survivors may frequently recall the abuse, fear revealing the abuse secret, have nightmares, and suffer sexual anxieties—all of which fuel muscular tension and emotional stress that encourage chronic headaches and migraines.
In a 2007 study of 161 patients with serious headache problems, a whopping 40% of those who suffered from chronic daily headaches also had a history of sexual and/or physical abuse.
Gastrointestinal (GI) disorders. In clinical settings, women and men who were sexually abused as children are more likely to report GI problems, such as irritable bowel syndrome, abdominal pain, diarrhea and nausea, than patients who were not abused. Some studies have found that as many as half of sexually abused women suffer from some type of GI symptom.
In addition, survivors of sexual abuse with GI problems report more medical symptoms, greater general pain, more lifetime surgeries and significantly higher amounts of disability due to the illness than non-sexually abused peers.
Fibromyalgia.Increasing evidence indicates that women who have been sexually abused are more likely to develop fibromyalgia, a syndrome characterized by chronic widespread pain, multiple “tender points” on various parts of the body, fatigue and sleep disturbances. (Fibromyalgia in men who have been sexually abused has not been widely studied.) On-going stress and depression related to abuse might be impairing sensory processing in the central nervous system, causing pain.
Chronic pelvic pain.Women who have been sexually abused tend to experience more chronic pelvic pain—50% by some estimates— including painful intercourse. One source of pelvic pain is vaginismus, a reflexive tightening of the vaginal muscles that can occur—even in loving sexual relationships—as women unconsciously seek to avoid further trauma or pain. Overtime, chronically tight vaginal muscles can shrink and atrophy, causing even more sexual difficulties. Male survivors have reported problems with recurrent rectal pain.
What survivors must do to help protect their health…
Don’t ignore your history.If you are a sexual abuse survivor who is concerned about or experiencing mental health problems, sexual problems, and/or unexplained physical ailments, seek professional help from a psychologist, counselor or certified sex therapist trained in sexual abuse treatment.
Classic sexual abuse recovery books, such as The Courage to Heal, Victims No Longer and The Sexual Healing Journey, offer effective healing strategies for both women and men. Also, investigate sexual abuse survivors’ groups and on-line resources such as Adult Survivors of Child Abuse (www.ascaSupport.org), Survivors of Incest Anonymous (www.siawso.org), and the Rape, Abuse & Incest National Network (www.rainn.org).
Speak to your doctor.Talk candidly with your physician so that he/she can factor your sexual abuse history into preventive care and the diagnosis of any health problems. Informed health care workers can make a special effort to help you feel safe during invasive exams and procedures, such as Pap smears for women and prostate exams for men.
Be sure to adopt a healthy lifestyle.Develop daily health habits that keep you strong, reduce your stress levels, and decrease your risk for health problems. These include following a healthful diet… getting seven to eight hours of sleep per night…exercising three to five times a week…and learning body- and brain-calming techniques, such as yoga, tai chi and meditation. Physical therapy can be beneficial for treating pelvic pain disorders.
Pay attention to your sexual health.Sexual abuse is not only an attack on one’s body, but also an attack on one’s sexuality. It can establish negative sexual attitudes and behaviors that impair healthy intimacy and long-term sexual pleasure, such as approaching sex as an obligation, not feeling present during sex, and engaging in out-of-control, harmful and compulsive sex. You may need to “relearn”—or even learn for the first time—that sex can be an expression of mutual respect and caring in a loving relationship. Healing your sexuality allows you to tackle the root cause of trauma-related medical conditions, thus improving your mental health, as well as your physical well-being.
[Note: Article references are available upon request]