Obstetrics & Gynecology

Skip Navigation LinksHome > December 2008 - Volume 112 - Issue 6 > Distress and Pain During Pelvic Examinations: Effect of Sexu...
Obstetrics & Gynecology:
doi: 10.1097/AOG.0b013e31818e4678
Original Research

Distress and Pain During Pelvic Examinations: Effect of Sexual Violence

Weitlauf, Julie C. PhD1,2,3; Finney, John W. PhD1; Ruzek, Josef I. PhD2,4; Lee, Tina T. MD, MS5; Thrailkill, Ann MSN, APRN6; Jones, Surai MS1; Frayne, Susan M. MD, MPH1,7

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Abstract

OBJECTIVE: To estimate the range and severity of distress and pain during pelvic examinations among female veterans with and without histories of sexual violence, and to examine whether posttraumatic stress disorder explains additional variance in examination-related distress and pain above that accounted for by exposure to sexual violence.

METHODS: We employed a cross-sectional cohort design in which 67 selected female veterans completed self-administered questionnaires to assess history of sexual violence and experiences of distress and pain associated with the pelvic examination. A subsample of 49 completed an assessment for posttraumatic stress disorder approximately 2 weeks later.

RESULTS: Distress associated with the pelvic examination was highest for women with prior sexual violence and posttraumatic stress disorder (median 5.49), next highest for women with sexual violence only (median 2.44), and lowest for women with neither (median 0), P=.015. Higher ratings of pain were also found among women with sexual violence (median 2.5) compared with those without (median 0), P=.04. However, posttraumatic stress disorder was not linked with increased pain from speculum insertion beyond that accounted for by sexual violence; limited power may have precluded detection of this effect.

CONCLUSION: Distress and pain during pelvic examinations may indicate a history of previous sexual violence, particularly in those with posttraumatic stress disorder. Extra sensitivity to the special needs of this population is warranted and may contribute positively to the quality of patients' experiences.

LEVEL OF EVIDENCE: II

© 2008 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.

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