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Medical News and Perspectives
September 14, 2011

Group Advises Clinicians to Routinely Screen Women for Sexual Assault History

JAMA. 2011;306(10):1072. doi:10.1001/jama.2011.1240

During medical visits, clinicians should routinely screen their female patients, particularly those who report pelvic pain, pain during menstruation, or sexual dysfunction, for a history of sexual assault, according to a new recommendation from the American College of Obstetricians and Gynecologists.

As many as 18% of women report having been raped or having experienced an attempted rape in their lifetime, according to the National Violence Against Women Survey, which was sponsored by the US Centers for Disease Control and Prevention and the National Institute of Justice and collected data from a nationally representative sample of women and men between 1995 and 1996 (https://www.ncjrs.gov/pdffiles1/nij/183781.pdf). Such assaults may be associated with both acute and long-term health consequences, including traumatic injuries, a risk of pregnancy, sexually transmitted diseases, unexplained pain, or sexual dysfunction. They also may experience both short-term and long-psychiatric conditions, according to the recommendation. In the immediate aftermath of the attack, women often experience a rape-trauma syndrome that may last for days or weeks. This acute reaction may include generalized pain, eating and sleep problems, emotional reactions, and mood swings. After this initial phase, a woman may have flashbacks, nightmares, and phobias. These women may also develop posttraumatic stress disorder or substance abuse problems.

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