Chronic pelvic pain and previous sexual abuse

Objective: To determine whether there is an association between history of sexual abuse and development of chronic pelvic pain. Methods: We studied 36 women with chronic pelvic pain, 23 with chronic low back pain, and 20 healthy women with reference to experience of sexual abuse, physical violence, and emotional neglect in childhood. Semistructured interviews were used to collect data. Assessment of severity of sexual abuse was based on Russell's criteria, and emotional and physical abuse were determined according to Briere's and Adler's definitions, respectively. Results: In terms of experience of sexual abuse in general, the three groups did not differ statistically significantly from each other (P =.128). However, 22% of patients with chronic pelvic pain were sexually abused before their 15th birthdays, significantly more frequently than the other two groups (chronic low back pain 0%, P =.019, pain-free control 0%, P =.028). Women with chronic pelvic pain were exposed more frequently to physical violence (38%) and suffered more emotional neglect (25%) in their childhoods than women in the pain-free control group (physical abuse 5%, P =.012; emotional abuse 0%, P =.018). With regard to physical abuse and emotional neglect, the women with chronic pelvic pain did not differ from those with chronic low back pain (physical abuse 30.4%, P =.385; emotional abuse 21.7%, P =.571). Conclusion: Besides physical and emotional trauma, there is a significant association between sexual victimization before age 15 years and later chronic pelvic pain. (Obstet Gynecol 2000;96:929-33. (C) 2000 by The American College of Obstetricians and Gynecologists.).