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Sexual violence occurs throughout the world. A simple definition is any sexual act for which consent is not obtained or freely given, according to the Centers for Disease Control and Prevention (CDC). Rape, sexual coercion, and unwanted sexual contact are a few examples.

While many people heal fully in time, traumatic events like these may contribute to long-lasting health issues such as heart disease, gastrointestinal disorders, and certain mental health conditions. Being aware of these possibilities can help you — and your health care clinicians, if you choose to share with them — identify and respond to health issues promptly.

Our trauma doesn’t have to define us. Knowing how to get proper treatment and support can help people who have experienced sexual violence live fulfilling, healthy lives.

Who is affected by sexual violence?

Statistics vary on different forms of sexual violence. One in four women and one in 26 men in the US report rape or attempted rape during their lifetime, for example.

Anyone can experience sexual violence. But it disproportionately impacts certain groups, such as women, people who are racially or ethnically marginalized or who identify as LGBTQ+, and people with low incomes.

Possible emotional effects of sexual violence: What to know

Most people who experience sexual assault report that it affects their mental health. Depression and anxiety are very common after sexual assault. So is post-traumatic stress disorder (PTSD). A review of multiple studies estimates that 75% of people have symptoms of PTSD within a month of the incident, and about 40% continue to have PTSD one year after the incident.

PTSD symptoms may include

• flashbacks
• distressing or intrusive memories or nightmares
• severe anxiety
• dissociation.

People with PTSD may feel numb, angry, helpless, or overwhelmed. They may also avoid triggers that remind them of the traumatic event, like certain places, smells, or objects.

Remember, your mental health is an important part of your overall health and well-being. Consider finding or asking for a referral for a mental health specialist who specializes in trauma-focused psychotherapy. This might include cognitive processing therapy, exposure-based therapy, or eye movement desensitization and reprocessing (EMDR) therapy.

Possible health effects following sexual violence: What to know

Sexual violence can have immediate health effects, of course, and reaching out to get help is important.

Yet weeks, months, or even years later, some — though not all — people develop health issues related to their trauma. Research suggests sexual violence may increase risk for some chronic health conditions, such as

• heart disease
• diabetes
• high blood pressure
• chronic pain, including pelvic pain
• frequent headaches or migraines
• irritable bowel syndrome
• substance use disorder, including opiate use.

Seeking treatment can support your healing and well-being. Consider talking to your health care provider if you think you may be experiencing any of these symptoms or conditions.

How do I talk to my doctor about my history of sexual assault?

It’s important to feel safe and comfortable with your health provider. Here are four helpful tips to consider when seeking health care:

• Ask about trauma-informed care. While sometimes your choice of provider is limited, you may be able to ask to see a clinician who provides trauma-informed care. Trauma-informed care acknowledges how trauma impacts our health and promotes an individual’s sense of safety and control.
• Share as little or as much as you like. If you’re comfortable, you can tell your clinician you have a history of sexual assault or trauma. It is your choice whether you want to discuss your trauma history with your health professional. If you choose not to, you can still seek care for any health issues related to your sexual assault. This is a confidential part of your medical record, like any other part of your medical history.
• Starting a conversation. If you decide to share, you can start the conversation with one of these examples:
  • “I want you to know I have a history of trauma.”
  • “My trauma continues to affect my health today in [insert ways].”

If the provider asks follow-up questions about your traumatic experience, know that you can provide as little or as much detail as you feel comfortable sharing.

• Medical record confidentiality. Ask if your health care institution provides any extra levels of confidentiality for your medical record. Sometimes, this includes additional access restrictions or passwords to enter your health record. This can be especially important if you have an abusive partner, or another person that you are concerned will try to inappropriately gain access to your medical records.

How can you prepare for a physical exam and talk to a clinician?

• Know that you have choices. A physical exam may help you get care you want or need to address a health issue. Yet sometimes people who have been sexually assaulted find physical exams stressful, difficult, or even traumatic. If your clinician would like to perform a physical exam, know that you can always decline or schedule it for another day or time.
• Consider having a support person present. Sometimes a support person like a good friend may make you more comfortable during your visit or exam. You can also ask the provider to have a second staff member in the room, and request a gender preference.
• Ask the provider to explain things before each step. Before the exam, you can ask the clinician to make sure you understand the steps of the exam. Remember, you can choose to pause or stop the exam at any time.
• Your consent matters. No matter the setting, you always have the right to decide how and when your body is examined and/or touched. All health care providers are held to professional and ethical standards to protect your rights. If a clinician violates this, you have the right to report the incident to the health care employer and/or local law enforcement, and to seek care elsewhere.

A few final thoughts

Sexual violence is never okay under any circumstances. If this has happened to you, know that it is not your fault.

Traumatic experiences like sexual assault can affect the body and mind. They may increase the risk of long-term health issues such as PTSD, depression, substance use disorder, high blood pressure, and chronic pelvic pain. Yet all health conditions related to sexual assault can be effectively treated. And most people who experience trauma heal and go on to live meaningful, fulfilling lives.

About the Author

Rose McKeon Olson, MD, MPH, Contributor

Dr. Rose McKeon Olson is an associate physician in the department of medicine at Brigham and Women’s Hospital, and an instructor of medicine at Harvard Medical School. She has special research interests in trauma-informed care and … See Full Bio View all posts by Rose McKeon Olson, MD, MPH

I must have seen commercials for Prevagen 50 times: story after story from everyday people who describe improvement in memory once they began taking Prevagen. And perhaps you recall older commercials playing off the idea that many people take supplements that boast of gut, joint, and heart health claims. Those commercials memorably asked, “So why wouldn’t you take something for the most important part of you… your brain? With an ingredient originally found in jellyfish! Healthier brain, better life!”

Never mind that the ingredient from jellyfish (apoaequorin) that was supposed to deliver these benefits has no known role in human memory. Or that many experts believe supplements like this are most likely digested in the stomach and never wind up anywhere near the brain.

Can a supplement actually improve memory? If it doesn’t work, why is the manufacturer allowed to suggest it does? And if apoaequorin is so great, why aren’t jellyfish smarter (as a colleague of mine wonders)?

Mind the gap between graphics and reality

A bar graph in the older ads showed a rise from 5% to 10% to 20% over 90 days in “recall tasks,” though exactly what that meant was never explained. Nor were we told how many people were studied or given any information about effects on memory after 90 days.

One small, company-sponsored study reported improvements in memory after people took apoaequorin. However, the published version demonstrated improvements only in a subset of study participants. And the real-world impact of these changes is uncertain. The study authors recommended additional research to clarify its effectiveness. But I’ve been unable to find any additional, high-quality, independent studies showing the impact of Prevagen or apoaequorin on human memory.

The Prevagen case resolved

The US Federal Trade Commission (FTC) and the New York state attorney general were also unconvinced about the supplement’s benefits. Back in 2017, they charged the supplement maker with false advertising. Fast forward to February 2024, when a New York jury found that many of the supplement’s claims were not supported by reliable evidence, and some (but not all) of the claims were “materially misleading.”

In December 2024, the FTC and New York attorney general won their lawsuit. Now the makers of Prevagen are prohibited from claiming that the supplement can improve brain function or memory.

Supplement claims sound good — so why the disclaimers?

There are many thousands of supplements marketed for hundreds of conditions. But it’s often hard to say if they’re doing much of anything.

For example:

• Glucosamine is often promoted as good for joint health. I have known patients who swore by it. But the best studies suggest this supplement has modest effects, if any.
• When vitamins tout heart-healthy claims, I think of the example of vitamin E, once considered potentially useful to prevent or treat heart disease. Yet, study after study showed no benefit. In fact, it may increase the risk of heart failure.
• As for probiotic supplements, no convincing evidence shows that their use improves digestive health or prevents digestive disease in healthy people.

So when you’re considering supplements, be skeptical of the benefits touted and remember the standard disclaimer stamped on each one: “These statements have not been evaluated by the FDA.”

What are the rules?

Supplement makers are bound by a few basic rules set by the FTC and FDA:

• They can make truthful claims about connections between their supplement and the body’s “structure and function.” For example, a vitamin maker touting calcium in a product can say that calcium is important for bone health — although it’s also true that calcium supplements may offer little or nothing for most people with healthy bones, diets rich in calcium, and no medical condition requiring extra calcium.
• They cannot claim their product treats or prevents a particular disease. That disclaimer, which may seem to contradict marketing promises, must appear on every package. So, commercials suggesting that a supplement can reverse or slow Alzheimer’s disease, or any dementia, may run afoul of the rules on marketing supplements.

The FDA and FTC continue to provide key oversight to the dietary supplement industry. That’s a daunting task given the sheer volume of products on the market.

The bottom line

This country has an enormous appetite for dietary supplements. The supplement industry is now worth an estimated $70 billion or more, with as many as 100,000 products available for purchase.

But there’s a reason dietary supplements carry a disclaimer: “This product is not intended to diagnose, treat, cure, or prevent any disease.” This should remind us all to be wary of claims we see in ads for dietary supplements. Unlike prescription drugs, supplements are not thoroughly tested or evaluated. While dietary supplements might provide benefits in certain cases, it’s vitally important that their makers not make unfounded claims to exploit consumers.

I support the efforts of the FDA and FTC to regulate dietary supplements and their ads. But regardless of how effective their regulations are, it’s best to be skeptical about ads for products that seem too good to be true. There’s a good chance they are.

About the Author

Robert H. Shmerling, MD, Senior Faculty Editor, Harvard Health Publishing; Editorial Advisory Board Member, Harvard Health Publishing

Dr. Robert H. Shmerling is the former clinical chief of the division of rheumatology at Beth Israel Deaconess Medical Center (BIDMC), and is a current member of the corresponding faculty in medicine at Harvard Medical School. … See Full Bio View all posts by Robert H. Shmerling, MD