Abstract
This study aims to examine the relationship between chronic pelvic pain (CPP) and sexual abuse history, present literature findings, and increase awareness of healthcare professionals on the subject.
Within the scope of the review, clinical and epidemiological studies examining the relationship between CPP and abuse were scanned, and systematic reviews and meta-analyses were reviewed. The literature review used PubMed, Scopus, and Web of Science databases. In the studies, the effect of sexual abuse, sexual violence, and childhood sexual abuse on CPP was emphasized. The methodological quality and limitations of the included studies were analyzed and the findings obtained were compiled. Studies show that a significant portion of women with CPP have a history of abuse. There are findings that experiences such as sexual abuse and physical violence increase the risk of individuals developing chronic pain and other somatic symptoms in later life. In addition, it has been determined that psychological disorders contribute to the chronicity of CPP by increasing pain perception. Understanding the relationship between chronic pelvic pain and abuse necessitates the development of a more holistic approach to treatment approaches. Considering not only physical symptoms but also psychosocial factors is a very important factor in improving the quality of life of patients and the treatment process. This review makes an important contribution to understanding the relationship between CPP and abuse and aims to increase the awareness of health professionals
Keywords
References
- Panisch, L. S., Rogers, R. G., Breen, M. T., Nutt, S., Dahud, S., & Salazar, C. A. (2022). Childhood betrayal trauma, dissociation, and shame impact health-related quality of life among individuals with chronic pelvic pain. Child abuse & neglect, 131, 105744. https://doi.org/10.1016/j.chiabu.2022.105744
- Leow, H. W., Szubert, W., & Horne, A. W. (2018). 45% of UK gynaecologists think chronic pelvic pain is managed badly. European journal of obstetrics, gynecology, and reproductive biology, 224, 200–202. https://doi.org/10.1016/j.ejogrb.2018.03.014
- Vincent, K., & Evans, E. (2021). An update on the management of chronic pelvic pain in women. Anaesthesia, 76 Suppl 4, 96–107. https://doi.org/10.1111/anae.15421
- Latthe P, Latthe M, Say L, Gülmezoglu M. WHO systematic review of prevalence of chronic pelvic pain: a neglected reproductive health morbidity. BMC Public Health. 2006;7:1–7. https://doi.org/10.1186/1471-2458-6-177.
- Latthe P, Mignini L, Gray R, Hills R, Khan K. Factors predisposing women to chronic pelvic pain: systematic review. Br Med J. 2006; 55 (February). https://doi.org/10.1136/bmj.38748.697465.55.
- ACOG Committee Opinion No. 777: Sexual Assault. (2019). Obstetrics and gynecology, 133(4), e296–e302. https://doi.org/10.1097/AOG.0000000000003178
- Panisch, L. S., & Tam, L. M. (2020). The Role of Trauma and Mental Health in the Treatment of Chronic Pelvic Pain: A Systematic Review of the Intervention Literature. Trauma, violence & abuse, 21(5), 1029–1043. https://doi.org/10.1177/1524838018821950
- World Health Organization. (2021). Violence against women prevalence estimates, 2018: global, regional and national prevalence estimates for intimate partner violence against women and global and regional prevalence estimates for non-partner sexual violence against women. https://www.who.int/publications/i/item/9789240022256
- Thomas, E., Moss-Morris, R., & Faquhar, C. (2006). Coping with emotions and abuse history in women with chronic pelvic pain. Journal of psychosomatic research, 60(1), 109–112. https://doi.org/10.1016/j.jpsychores.2005.04.011
- As-Sanie, S., Clevenger, L. A., Geisser, M. E., Williams, D. A., & Roth, R. S. (2014). History of abuse and its relationship to pain experience and depression in women with chronic pelvic pain. American journal of obstetrics and gynecology, 210(4), 317.e1–317.e8. https://doi.org/10.1016/j.ajog.2013.12.048
- DUNCAN, C. H., & TAYLOR, H. C., Jr (1952). A psychosomatic study of pelvic congestion. American journal of obstetrics and gynecology, 64(1), 1–12. https://doi.org/10.1016/s0002-9378(16)38730-0
- Weiss, E. L., Longhurst, J. G., & Mazure, C. M. (1999). Childhood sexual abuse as a risk factor for depression in women: psychosocial and neurobiological correlates. The American journal of psychiatry, 156(6), 816–828. https://doi.org/10.1176/ajp.156.6.816
- Jamieson, D. J., & Steege, J. F. (1997). The association of sexual abuse with pelvic pain complaints in a primary care population. American journal of obstetrics and gynecology, 177(6), 1408–1412. https://doi.org/10.1016/s0002-9378(97)70083-8
- Walker, E., Katon, W., Harrop-Griffiths, J., Holm, L., Russo, J., & Hickok, L. R. (1988). Relationship of chronic pelvic pain to psychiatric diagnoses and childhood sexual abuse. The American journal of psychiatry, 145(1), 75–80. https://doi.org/10.1176/ajp.145.1.75
- Sachs-Ericsson, N., Kendall-Tackett, K., & Hernandez, A. (2007). Childhood abuse, chronic pain, and depression in the National Comorbidity Survey. Child abuse & neglect, 31(5), 531–547. https://doi.org/10.1016/j.chiabu.2006.12.007
- Fenton B. W. (2007). Limbic associated pelvic pain: a hypothesis to explain the diagnostic relationships and features of patients with chronic pelvic pain. Medical hypotheses, 69(2), 282–286. https://doi.org/10.1016/j.mehy.2006.12.025
- Bourdon, M., Antoine, V., Combes, U., Maitrot-Mantelet, L., Marcellin, L., Maignien, C., Chapron, C., & Santulli, P. (2023). Severe pelvic pain is associated with sexual abuse experienced during childhood and/or adolescence irrespective of the presence of endometriosis. Human reproduction (Oxford, England), 38(8), 1499–1508. https://doi.org/10.1093/humrep/dead119
- Garza-Leal, J. G., Sosa-Bravo, F. J., Garza-Marichalar, J. G., Soto-Quintero, G., Castillo-Saenz, L., & Fernández-Zambrano, S. (2021). Sexual abuse and chronic pelvic pain in a gynecology outpatient clinic. A pilot study. International urogynecology journal, 32(5), 1285–1291. https://doi.org/10.1007/s00192-021-04772-4
- Chapron, C., Marcellin, L., Borghese, B., & Santulli, P. (2019). Rethinking mechanisms, diagnosis and management of endometriosis. Nature reviews. Endocrinology, 15(11), 666–682. https://doi.org/10.1038/s41574-019-0245-z
Abstract
Bu çalışma, kronik pelvik ağrı (KPA) ile cinsel istismar geçmişi arasındaki ilişkiyi incelemeyi, literatür bulgularını sunmayı ve sağlık profesyonellerinin konu hakkındaki farkındalığını artırmayı amaçlamaktadır. Derleme kapsamında, KPA ve istismar arasındaki ilişkiyi inceleyen klinik ve epidemiyolojik araştırmalar taranmış, sistematik derlemeler ve meta-analizler gözden geçirilmiştir. Literatür taraması, PubMed, Scopus ve Web of Science gibi veri tabanlarından yapılmıştır. Araştırmalarda, özellikle cinsel istismar, cinsel şiddet ve çocukluk dönemi cinsel istismarının KPA üzerindeki etkisi vurgulanmıştır. Dahil edilen çalışmaların metodolojik kalitesi ve sınırlılıkları analiz edilerek, elde edilen bulgular derlenmiştir. Araştırmalar, KPA'ya sahip kadınların önemli bir kısmının istismar geçmişine sahip olduğunu göstermektedir. Cinsel istismarın ve fiziksel şiddet gibi deneyimlerin, bireylerin ilerideki yaşamlarında kronik ağrı ve diğer somatik belirtiler geliştirme riskini artırdığına dair bulgular bulunmaktadır. Ayrıca, psikolojik bozuklukların ağrı algısını artırarak KPA'nın kronikleşmesine katkıda bulunduğu belirlenmiştir.Kronik pelvik ağrı ile istismar arasındaki ilişkinin anlaşılması, tedavi yaklaşımlarında daha bütüncül bir yaklaşım geliştirilmesini zorunlu kılmaktadır. Sadece fiziksel semptomların değil, aynı zamanda psikososyal faktörlerin de dikkate alınması, hastaların yaşam kalitesini artırmada ve tedavi süreci için oldukça önemli bir faktördür. Bu derleme, KPA ve istismar ilişkisini anlamada önemli bir katkı sunmakta ve sağlık profesyonellerinin farkındalığını artırmayı hedeflemektedir.
References
- Panisch, L. S., Rogers, R. G., Breen, M. T., Nutt, S., Dahud, S., & Salazar, C. A. (2022). Childhood betrayal trauma, dissociation, and shame impact health-related quality of life among individuals with chronic pelvic pain. Child abuse & neglect, 131, 105744. https://doi.org/10.1016/j.chiabu.2022.105744
- Leow, H. W., Szubert, W., & Horne, A. W. (2018). 45% of UK gynaecologists think chronic pelvic pain is managed badly. European journal of obstetrics, gynecology, and reproductive biology, 224, 200–202. https://doi.org/10.1016/j.ejogrb.2018.03.014
- Vincent, K., & Evans, E. (2021). An update on the management of chronic pelvic pain in women. Anaesthesia, 76 Suppl 4, 96–107. https://doi.org/10.1111/anae.15421
- Latthe P, Latthe M, Say L, Gülmezoglu M. WHO systematic review of prevalence of chronic pelvic pain: a neglected reproductive health morbidity. BMC Public Health. 2006;7:1–7. https://doi.org/10.1186/1471-2458-6-177.
- Latthe P, Mignini L, Gray R, Hills R, Khan K. Factors predisposing women to chronic pelvic pain: systematic review. Br Med J. 2006; 55 (February). https://doi.org/10.1136/bmj.38748.697465.55.
- ACOG Committee Opinion No. 777: Sexual Assault. (2019). Obstetrics and gynecology, 133(4), e296–e302. https://doi.org/10.1097/AOG.0000000000003178
- Panisch, L. S., & Tam, L. M. (2020). The Role of Trauma and Mental Health in the Treatment of Chronic Pelvic Pain: A Systematic Review of the Intervention Literature. Trauma, violence & abuse, 21(5), 1029–1043. https://doi.org/10.1177/1524838018821950
- World Health Organization. (2021). Violence against women prevalence estimates, 2018: global, regional and national prevalence estimates for intimate partner violence against women and global and regional prevalence estimates for non-partner sexual violence against women. https://www.who.int/publications/i/item/9789240022256
- Thomas, E., Moss-Morris, R., & Faquhar, C. (2006). Coping with emotions and abuse history in women with chronic pelvic pain. Journal of psychosomatic research, 60(1), 109–112. https://doi.org/10.1016/j.jpsychores.2005.04.011
- As-Sanie, S., Clevenger, L. A., Geisser, M. E., Williams, D. A., & Roth, R. S. (2014). History of abuse and its relationship to pain experience and depression in women with chronic pelvic pain. American journal of obstetrics and gynecology, 210(4), 317.e1–317.e8. https://doi.org/10.1016/j.ajog.2013.12.048
- DUNCAN, C. H., & TAYLOR, H. C., Jr (1952). A psychosomatic study of pelvic congestion. American journal of obstetrics and gynecology, 64(1), 1–12. https://doi.org/10.1016/s0002-9378(16)38730-0
- Weiss, E. L., Longhurst, J. G., & Mazure, C. M. (1999). Childhood sexual abuse as a risk factor for depression in women: psychosocial and neurobiological correlates. The American journal of psychiatry, 156(6), 816–828. https://doi.org/10.1176/ajp.156.6.816
- Jamieson, D. J., & Steege, J. F. (1997). The association of sexual abuse with pelvic pain complaints in a primary care population. American journal of obstetrics and gynecology, 177(6), 1408–1412. https://doi.org/10.1016/s0002-9378(97)70083-8
- Walker, E., Katon, W., Harrop-Griffiths, J., Holm, L., Russo, J., & Hickok, L. R. (1988). Relationship of chronic pelvic pain to psychiatric diagnoses and childhood sexual abuse. The American journal of psychiatry, 145(1), 75–80. https://doi.org/10.1176/ajp.145.1.75
- Sachs-Ericsson, N., Kendall-Tackett, K., & Hernandez, A. (2007). Childhood abuse, chronic pain, and depression in the National Comorbidity Survey. Child abuse & neglect, 31(5), 531–547. https://doi.org/10.1016/j.chiabu.2006.12.007
- Fenton B. W. (2007). Limbic associated pelvic pain: a hypothesis to explain the diagnostic relationships and features of patients with chronic pelvic pain. Medical hypotheses, 69(2), 282–286. https://doi.org/10.1016/j.mehy.2006.12.025
- Bourdon, M., Antoine, V., Combes, U., Maitrot-Mantelet, L., Marcellin, L., Maignien, C., Chapron, C., & Santulli, P. (2023). Severe pelvic pain is associated with sexual abuse experienced during childhood and/or adolescence irrespective of the presence of endometriosis. Human reproduction (Oxford, England), 38(8), 1499–1508. https://doi.org/10.1093/humrep/dead119
- Garza-Leal, J. G., Sosa-Bravo, F. J., Garza-Marichalar, J. G., Soto-Quintero, G., Castillo-Saenz, L., & Fernández-Zambrano, S. (2021). Sexual abuse and chronic pelvic pain in a gynecology outpatient clinic. A pilot study. International urogynecology journal, 32(5), 1285–1291. https://doi.org/10.1007/s00192-021-04772-4
- Chapron, C., Marcellin, L., Borghese, B., & Santulli, P. (2019). Rethinking mechanisms, diagnosis and management of endometriosis. Nature reviews. Endocrinology, 15(11), 666–682. https://doi.org/10.1038/s41574-019-0245-z
Details
| Primary Language | English |
|---|---|
| Subjects | Obstetrics and Gynaecology |
| Journal Section | Reviews |
| Authors | |
| Publication Date | August 25, 2025 |
| Submission Date | February 4, 2025 |
| Acceptance Date | April 13, 2025 |
| Published in Issue | Year 2025Volume: 64 Issue: Özel Sayı: 1 (11. Ulusal Ürojinekoloji Kongresi Bildiri Kitapçığı) |
