Life after sexual assault: PTSD and its effects on reproductive health

By Natasha Weiss


TW: Sexual assault mention


“After trauma, the world is experienced with a different nervous system. The survivor’s energy now becomes focused on suppressing inner chaos, at the expense of spontaneous involvement in their lives. "

— Dr. van der Kolk, "The Body Keeps The Score"



The month of April marks Sexual Assault Awareness Month, SAAM, to promote education on sexual assault and clarity around consent.

It’s understandable to be triggered, frustrated, pissed off, annoyed, or all of the above at just how commonplace sexual assault is around the world, and how it’s grossly mishandled.

A huge area that often goes undiscussed, are the long term effects on people who have experienced sexual assault. The mental, the emotional, and sometimes - the physical.

Aftershock

It comes at no surprise, that rates of PTSD, Post Traumatic Stress Disorder, are drastically higher amongst those who have experienced sexual assault.

While the effects manifest differently for everyone, PTSD warps your nervous system. It puts you in a perpetual state of anxiety and trepidation. PTSD can hinder people’s ability to work, affect their relationships and friendships, and overtime can negatively impact their physical health.

The mental anguish that comes with PTSD can feel crippling. It can leave one feeling hopeless and disassociated. Many people reach for their own coping mechanisms to try to balance out the pain they’re in. On one level, this is an incredibly intelligent adaptive response of the body, but usually, these behaviors can be more harmful than good. Smoking, substance abuse, and abnormal eating habits are all typical responses of someone trying to make sense of and deal with living after a traumatic event — but they come with a cost.

For those who have developed PTSD after experiencing sexual assault and/or violence, these coping mechanisms become even more nuanced. The added layers of shame and blame that often come into play, perpetuate whatever symptoms someone is already experiencing. It also may lead them to engage in behaviors or enter into situations that are triggering, or cause further trauma.


For those who have developed PTSD after experiencing sexual assault and/or violence, these coping mechanisms become even more nuanced. The added layers of shame and blame ... perpetuate whatever symptoms someone is already experiencing.

It’s All Connected

With the body in a constant state of stress and dysregulation, PTSD can ripple out to every area of someone’s health, causing long term repercussions. The strong correlation between PTSD and chronic disorders like high blood pressure, fibromyalgia, and heart disease suggests that what appears to be a mental health disorder, can affect the rest of the body.

When you look critically at the human stress response, it makes total sense. The body can not be compartmentalized. Any chronic ailment, especially one that causes consistent inflammation, throws off the rest of the body, the immune system, and can cause disharmony in hormone regulation. Hormones that dictate our stress levels, ability to sleep, our appetites, and of course — our reproductive health. Being in a state of chronic stress can suppress the sex hormones estrogen and progesterone. When these are off-balance, it can impact menstruation, libido, PMS.


When you look critically at the human stress response, it makes total sense. The body can not be compartmentalized.

The Body Keeps Score

As if facing sexual assault wasn’t hard enough, many people then go on to develop painful disorders that can interfere with their daily lives. One study found that 69 percent of women who had experienced childhood sexual abuse reported chronic pain, more hospitalizations, and more surgeries.

Another study that focused on women with CPP, chronic pelvic pain, suggested that traumatized, chronically stressed individuals lack the protective properties that come with cortisol, the stress hormone, which throws off the endocrine system and hormone regulation.

An imbalance in hormone regulation after abuse, including sexual, was associated with increased rates of clinically symptomatic uterine fibroids. Sexual abuse in early life has been associated with an increased risk of endometriosis, a painful condition where uterine tissues grow outside the uterus.

Unfortunately, data is still limited, and what does exist is correlational, without having clear explanations as to why.

In his bestselling book, “The Body Keeps Score”, Dr. Bessel van der Kolk gives an in-depth look into how trauma stores itself in the body, changes the brain and causes malfunctions in the nervous system. His background as both a researcher as well as a clinical therapist has allowed him to paint a multidimensional picture of how trauma, including sexual assault, can alter someone’s health and wellbeing. This book is an incredibly useful resource to give a glimpse as to what “rewiring” the brain means in terms of healing, and normalizes with empirical and anecdotal evidence, what so many feel like they’re experiencing in isolation.


“After trauma, the world is experienced with a different nervous system. The survivor’s energy now becomes focused on suppressing inner chaos, at the expense of spontaneous involvement in their lives. These attempts to maintain control over unbearable physiological reactions can result in a whole range of physical symptoms, including fibromyalgia, chronic fatigue, and other autoimmune diseases. This explains why it is critical for trauma treatment to engage the entire organism, body, mind, and brain.”

This explains why it is critical for trauma treatment to engage the entire organism, body, mind, and brain.

On the process of healing, Dr. van der Kolk beautifully explains that “Beneath the surface of the protective parts of trauma survivors there exists an undamaged essence, a Self that is confident, curious, and calm, a Self that has been sheltered from destruction by the various protectors that have emerged in their efforts to ensure survival. Once those protectors trust that it is safe to separate, the Self will spontaneously emerge, and the parts can be enlisted in the healing process.”

It’s worth noting that, while most of the data referenced in this piece is gendered, and research is focused on “women”, this information can be applied to anyone with a vulva, regardless of gender identity.


You Are Not Alone

If you are one of the one in four people who have experienced sexual assault, you are not alone, and it’s not your fault. Healing is a non-linear journey, and one that looks different for everyone, but it’s entirely possible.

RAINN has a comprehensive list of hotlines, centers, legal resources, and organizations that support people who have experienced any form of sexual assault.



Want to read more about this topic?

Check out: Masturbation Meditation: Reclaiming pleasure, connection, and a sense of home in my body


Natasha Weiss is a freelance writer who works with Public Goods, a company that sells eco-friendly household essentials such as essential oils, razor blades and hand soap. Check out their blog for a wide range of topics: everything from cough remedies and face washes to decrystallizing honey and wool dryer balls.


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