Recurrent pelvic pain in people who disclose domestic and sexual violence: a call for a trauma-informed approach

People who experience violence, including sexual violence, can experience long-term negative health outcomes.1 Furthermore, people who experience sexual violence are significantly more likely to present with pelvic pain, including reattendances with recurrent symptoms at sexual heath, gynaecology or primary care services.2–6 Pelvic pain in people with a uterus is a common presentation to sexual health clinics where the differential diagnosis is wide (eg, sexually transmitted infections (STIs), infections, gynaecological pathologies, gastrointestinal disease, urological conditions, sexual dysfunction). Most people who attend sexual health clinics with pelvic pain are examined with a speculum, undergo a pelvic examination and are tested for STIs. Those with symptoms and clinical signs are managed presumptively as having pelvic inflammatory disease (PID). In Brighton, around 30 000 people per year attend our sexual health clinics. We routinely discuss, document and code current or previous sexual and domestic violence. All patients who are diagnosed as PID are tested for Neisseria gonorrhoeae, Chlamydia trachomatis and Mycoplasma genitalium using nucleic acid amplification tests (NAATs), Candida albicans and bacterial vaginosis using microscopy, and HIV and Treponema pallidum using …

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