# 13 | How Sexual Violence Affects Women’s Health
Sexual violence is one of the most widespread public health issues of our time. The World Health Organization estimates that approximately 1 in 3 women will experience physical or sexual violence during their lifetime, but when we talk about its consequences, the conversation almost always centres on mental health, and rightfully so. However, what receives far less attention is what happens to the body: the physical health toll that can quietly accumulate over months and years, shaping a woman's relationship with her own health in ways that are rarely connected back to their source.
The link between sexual violence and physical health outcomes is well-documented across decades of peer-reviewed research. Survivors are significantly more likely to live with chronic conditions across multiple body systems and these effects can persist long after the trauma itself sometimes across an entire lifetime.
Gynaecological and reproductive health tend to be among the most directly affected areas. Studies have consistently found higher rates of chronic pelvic pain, painful periods, painful intercourse and sexually transmitted infections among survivors of sexual violence. There is also growing evidence of an association between sexual trauma and conditions such as endometriosis, though researchers are still working to understand the precise biological pathways involved.
The nervous system bears a significant burden too. When the body experiences trauma, it activates a stress response releasing cortisol and adrenaline designed to be short-term. When trauma is repeated or ongoing, that stress response becomes chronically dysregulated. Research shows that survivors of sexual violence have measurably altered hypothalamic-pituitary-adrenal (HPA) axis function, which over time disrupts hormonal balance, immune regulation, sleep and even metabolic health. These consequences show up in blood tests, in symptoms, in the body's diminished ability to recover and regulate itself.
Chronic pain conditions are considerably more common among survivors too. A systematic review found that women with a history of sexual assault were substantially more likely to report fibromyalgia, chronic fatigue, persistent headaches, and irritable bowel syndrome. This connection runs through the neurobiology of trauma: prolonged stress sensitises the central nervous system over time, lowering the threshold at which pain is experienced and driving a sustained inflammatory response throughout the body. Gastrointestinal symptoms in particular are frequently reported, thought to be mediated through stress-related changes in the gut-brain axis and shifts in gut motility and microbiome composition.
Despite a strong and consistent evidence base, sexual violence is rarely discussed in routine clinical appointments. Survivors often present with chronic pelvic pain, unexplained fatigue, hormonal disruption, or recurrent infections; symptoms that are investigated in isolation, without any exploration of what might be driving them. Shame, fear of not being believed and a lack of trauma-informed practice across healthcare settings all contribute to this gap, leaving many women cycling through appointments and referrals without ever receiving care that addresses the full picture.
A 2022 review in The Lancet argued that trauma-informed care needs to become a standard rather than a specialist offering, noting that the failure to recognise sexual violence as a determinant of physical health leads directly to misdiagnosis, inappropriate treatment and suffering that could otherwise be addressed.
What Good Care Looks Like
Recovery is possible and it rarely moves in a straight line. For survivors living with the physical consequences of sexual violence, integrated care - combining gynaecological support, pain management and trauma-informed practice - consistently produces better outcomes than treating each symptom in isolation. If you are experiencing chronic symptoms and suspect they may be connected to past trauma, you are entitled to care that takes that seriously. You do not owe anyone your full history in order to receive thorough, compassionate treatment but you have every right to ask for it.
If you need immediate support, please reach out to a sexual violence support service or crisis line in your area. You do not have to carry this alone.
Medical Disclaimer: This article is intended for informational and educational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional regarding any symptoms or health concerns. HER is not a medical provider.