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Although chronic pelvic pain is normally caused by adhesions, endometriosis or infections, about half the cases treated have no identifiable pathology. A number of studies have found that women suffering from pelvic pain are consistently more likely to have a history of childhood sexual abuse, sexual assault or physical and sexual abuse by their partners.23 Other gynaecological problems associated o'rielly factor with sexual violence include vaginal o'rielly factor bleeding, vaginal discharge, painful menstruation, pelvic inflammatory disease and sexual dysfunction.24 Sexual assault also increases the risk for premenstrual distress, a condition that o'rielly factor affects up to 10 per cent of menstruating women and causes physical, mood and behavioural changes.25 Psychological problems Violence distorts the emotional lives of women and families. In Nicaragua, for instance, focus group studies found that many women considered the persistent psychological effects of domestic violence to be more severe and debilitating than the physical ones.
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