COMMENTARY

A History of Sexual Assault and Harassment? Why We Must Ask

Charles P. Vega, MD

Disclosures

November 06, 2018

Hello. I'm Dr Charles Vega, and I am a clinical professor of family medicine at the University of California at Irvine. Welcome to Medscape Morning Report, our 1-minute news story for primary care.

The #MeToo movement has mainly focused on holding men accountable for abusive behaviors toward women, including sexual assault and harassment. Less emphasis has been placed on the long-term health consequences—both psychological and physical—on the victims of sexual assault and harassment.

We know that the trauma of sexual abuse takes a toll on a woman's quality of life and ability to function. But less is known about the effects on her physical health.

Research presented at the 2018 meeting of the North American Menopause Society sheds light on this issue. As part of a study about hot flashes, the authors recruited more than 300 nonsmoking women, aged 40-60. They asked the women if they had ever experienced physical or verbal sexual harassment, and if they had ever been pressured into having some type of unwanted sexual contact.

One in five of the women (19%) reported having experienced workplace sexual harassment and 22% reported having been sexually assaulted. One in ten women had experienced both. Important variables, such as body mass index (BMI), physical activity, and alcohol consumption were similar regardless of the presence of sexual harassment or assault.

Women who had been sexually harassed were more than twice as likely to have stage 1 or 2 hypertension and insomnia. A history of sexual assault was associated with a higher likelihood of depression or anxiety, as well as poor sleep quality.

It's tempting to assume that people forget or "get over" traumatic events in their past as they grow older. This study shows that for many women, this isn't the case, and that sexual harassment and assault can continue to affect a woman's mental and physical health long after the event has taken place. That said, the authors of the study note that their study does not demonstrate causality or temporality between sexual harassment and assault and study outcomes.

What is clear is that having experienced sexual abuse, in the form of harassment or assault, is an important part of a woman's medical and psychological history. But clinicians won't know unless they ask, because many women hesitate to bring up what they might consider highly distressing events in their past. Discussing the potential link between those events and a woman's present and future health is a good place to start.

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