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Recurrent pelvic pain in people who disclose domestic and sexual violence: a call for a trauma-informed approach
  1. Rhian Jenkins1,
  2. Clare Taverner1,
  3. Justine Orme1,
  4. Natalie Edelman2,3,
  5. Colin Fitzpatrick1,
  6. Daniel Richardson1,4
  1. 1 Sexual Health & HIV, University Hospitals Sussex NHS Foundation Trust, Brighton, UK
  2. 2 Centre for Health Services Studies, University of Kent, Canterbury, UK
  3. 3 Trauma Informed Research Support and Training (TRUST), Brighton, UK
  4. 4 Global Health & Infection, Brighton and Sussex Medical School, Brighton, UK
  1. Correspondence to Professor Daniel Richardson, Sexual Health & HIV, University Hospitals Sussex NHS Foundation Trust, Brighton, UK; daniel.richardson7{at}nhs.net

https://doi.org/10.1136/sextrans-2024-056185

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    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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    Footnotes

    • Handling editor Anna Maria Geretti

    • X @natalieedelman

    • Presented at The data were presented at the 2023 BASHH conference in Llandudno in June 2023 (DOI: 10.1136/sextrans-BASHH-2023.142) as a poster.

    • Contributors DR, JO and NE designed this study. RJ, CT and CF extracted the data. RJ and DR analysed the data. RJ, CT, JO, NE, CF and DR all contributed to the final manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; internally peer reviewed.