Understanding chronic pelvic pain in women survivors of sexual violence: a qualitative study.

Abstract

Chronic pelvic pain (CPP) affects an estimated 14.8% of UK women. Survivors of sexual violence are more likely to experience CPP, but the relationship is complex and underexplored. Shame and stigma from both experiences may interact and influence help-seeking. To broaden understanding of how women survivors of sexual violence make personal meaning of CPP, and to consider clinical implications of findings. A qualitative study of UK community-recruited women who have survived sexual violence and who experience chronic pelvic pain (CPP). Ten participants were recruited via social media and engaged in individual, semi-structured online interviews about their experiences and understandings of sexual violence and CPP. Interviews were transcribed verbatim and analysed using reflexive Thematic Analysis. Three main themes were developed: (1) Healthcare professionals' attempts to silence women, who felt ignored, disbelieved or dismissed; (2) Treating the whole woman, describing the need for integrated, biopsychosocial approaches; and (3) A woman's place is in the resistance, highlighting women's active efforts to reclaim their narratives and pursue care. Shame was compounded across experiences, and women expressed frustration with fragmented care and assumptions about the psychological origins of pain. These results give insights into the complex meanings women survivors of sexual violence hold about their CPP, and how healthcare systems could better support them to explore and respond to those meanings. The aim should be compassionate care that recognises the complex biopsychosocial impact of sexual violence and CPP, while keeping women in control of their own care.