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Childhood sexual abuse and subsequent gynaecological conditions

University of Leeds Medical School, Clarendon Way, Leeds, UK.

James Drife, MD FRCOG FRCPEd FRCSEd HonFCOGSA, Professor of Obstetrics and Gynaecology

University of Leeds, Department of Obstetrics and Gynaecology, Clarendon Wing, Belmont Grove, Leeds, LS2 9NS, UK. email: j.o.drife{at}leeds.ac.uk (corresponding author)

Physical, sexual or emotional abuse in childhood occurs in all countries and social classes. Estimates of the prevalence of childhood sexual abuse among the general population vary from 7% to 38% but among gynaecological patients rates are generally between 15% and 20%. Rates are highest among women with chronic pelvic pain and those who have had gynaecological surgery. Childhood sexual abuse may cause adult depression, somatisation or neurological changes. Gynaecologists should remember that childhood sexual abuse is common. Empathic questioning about the possibility should be routinely included. Failure to do so may lead to inappropriate treatment, including unnecessary surgery. Women distressed by childhood sexual abuse should be offered appropriate referral.

Keywords Keywords / childhood sexual abuse / chronic pelvic pain / clinical approach / gynaecological symptoms