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Journal of General Internal Medicine

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01-11-2020 | Original Research

Early Life Sexual Trauma and Later Life Genitourinary Dysfunction and Functional Disability in Women

Authors: Pooja Lalchandani, BA, Nadra Lisha, PhD, Carolyn Gibson, PhD, Alison J. Huang, MD, MAS

Published in: Journal of General Internal Medicine | Issue 11/2020

Abstract

Background

Past research has examined the health outcomes of early sexual trauma in reproductive age women, but little is known about potential long-term effects in older age.

Objective

To examine associations between early life sexual trauma and later life sexual/genitourinary dysfunction and general functional disability in women.

Design

Cross-sectional analysis of nationally representative observational data from the National Social Life, Health, and Aging Project (2010–2011)

Participants

One thousand seven hundred forty-five US women aged ≥ 50 years

Main Measures

Two forms of early life sexual trauma (childhood sexual abuse and unwanted first sexual experience), sexual/genitourinary dysfunction (pain during sex, lack of pleasure during sex, urinary incontinence, other urinary symptoms), and general functional disability (difficulty performing 7 activities of daily living (ADLs) or 8 instrumental activities of daily living (IADLs)), assessed by interview and questionnaire.

Key Results

Of 1745 women, 11% reported a history of childhood sexual abuse and 39% an unwanted first sexual experience. Childhood sexual abuse was associated with later life sexual/genitourinary dysfunction (pain during sex [OR 1.9, 95% CI 1.1–3.3], other urinary problems [OR 1.9, 95% CI 1.2–3.1]), and difficulty with multiple ADLs/IADLs (walking across the room [OR 1.9, 95% CI 1.2–3.1], getting in or out of bed [OR 2.0, 95% CI 1.2–3.3], bathing [OR 2.0, 95% CI 1.2–3.5], prepping meals [OR 2.4, 95% CI 1.5–3.8], shopping for food [OR 1.6, 95% CI 1.0–2.4], and completing light work [OR 1.6, 95% CI 1.0–2.4]), after adjusting for age, race, and education. Unwanted first sexual experience was associated with later life lack of pleasure with sex (OR 1.7, 95% CI 1.1–2.5) and difficulty with ADLs/IADLs (walking one block [OR 1.5, 95% CI 1.1–2.1], completing light work [OR 1.6, 95% CI 1.1–2.1]) in adjusted analyses.

Conclusions

Early sexual trauma may be an under-recognized marker of risk of aging-related functional decline in women. Findings underline the importance of providing trauma-informed care for women across the aging spectrum.

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Title: Early Life Sexual Trauma and Later Life Genitourinary Dysfunction and Functional Disability in Women
Authors: Pooja Lalchandani, BA
Nadra Lisha, PhD
Carolyn Gibson, PhD
Alison J. Huang, MD, MAS
Publication date: 01-11-2020
Publisher: Springer International Publishing
Published in: Journal of General Internal Medicine / Issue 11/2020
Print ISSN: 0884-8734
Electronic ISSN: 1525-1497
DOI: https://doi.org/10.1007/s11606-020-06118-0

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Abstract

Background

Objective

Design

Participants

Main Measures

Key Results

Conclusions

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