Newswise -- European research in the June issue of The Lancet highlights how gynecologists could have an important role in identifying women who have experienced sexual, physical, and emotional abuse. A positive dialogue between gynecologists and their patients could ensure that abused women do not receive inappropriate medical treatment, and would help abused women being signposted to appropriate support services.

Previous research has highlighted a high prevalence of emotional, physical, and sexual abuse among women. Physical and sexual abuse is often associated with gynecological problems, although women rarely discuss abusive experiences with their gynecologists. Barbo Wijma from Linkoping University, Sweden, and colleagues estimated the prevalence of abuse among women attending gynecological clinics in five Nordic countries (Denmark, Norway, Sweden, Finland, and Iceland); they also assessed the frequency in which gynecologists identified abused patients.

Over 3,600 women attending gynecology departments completed a confidential questionnaire that included questions about a history of abuse. The ranges across the five countries of lifetime prevalence were 38-66 percent for physical abuse, 19-37 percent for emotional abuse, and 17-33 percent for sexual abuse. Not all abused women reported current ill-effects from the abusive experience. Most women (92-98 percent) had not talked to their gynaecologist about their experiences of abuse at their latest clinic visit.

Professor Barbo Wijma, of the Division of Womens Health, Department of Molecular & Clinical Medicine, Faculty of Health Sciences at Linkoping University comments, "Why should gynecologists know whether their patient has a history of abuse? First, gynecologists are strategically placed to be able to identify victims of abuse, and refer them to other community support services. Second, on a theoretical basis it can be assumed that a patient with earlier abuse has experienced trauma in situations in which she felt subordinate, powerless, and maybe dependent. The consultation situation for such a patient could have enough similarities with the traumatic situation to provoke flashbacks of the abuse and of the feelings she had when it occurred. These conditions increase the risk of abused women experiencing routine health-care procedures as abusive. Third, on an empirical level it could be argued that when the gynecologist and patient can discuss abuse they can also discuss the delicate issue of how to handle the consultation and the pelvic examination to avoid new trauma. A concrete outcome of such an approach might, for example, be an agreement not to do a pelvic examination at that time if the indications for the procedure would be outweighed by the risks."

Source: The Lancet