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ACEs and Gynecological Problems - A Conversation Starter

ACEs and Gynecological Problems - a Conversation Starter

In the culture in which I grew up, lingering effects of childhood abuse were seen as lack of will power, lack of faith in God or both. What a relief it was when I learned of the ACEs study and joined the ACEs Connection community five years ago!

As a victim of childhood sexual and institutional abuse and as an advocate for those with histories similar to mine, the ACEs study and subsequent research around ACEs brought many things into focus for me and helped frame my story in a way that has brought much healing in my life.

Over the past few years, besides keeping up with posts on the ACEs Connection website, I have read numerous books on ACEs including Childhood Disrupted, The Deepest Well, The Body Keeps the Score and Blind to Betrayal.  

A look through the index of any of these books will show pages where the physical effects of ACEs are discussed: autoimmune diseases, diabetes, cancer, obesity, stroke, heart disease and gastrointestinal problems. Those indices also include pages where estrogen, testosterone and progesterone are mentioned. But you will not see one reference to the sexual organs that those hormones affect or to gynecological problems women who experienced childhood sexual abuse (CSA) often deal with.

I experienced extreme gynecological problems - excessive bleeding, decidual casts, difficult childbirths, endometriosis - from the time my periods started until my ovaries and uterus were removed at the age of 37. Leaving these physical issues out of the ACEs discussion is disheartening to me, especially when research shows a link. (See the attached pdf.) 

This puzzles me. The other diseases linked to ACEs affect both men and women. Is this off advocates' radars because it's a woman's-only issue? Is it subconsciously linked to the long-held notion that women's menstrual problems are in their heads? Is it not included because it is too sensitive or taboo? Is it because women are embarrassed to talk about it? Is there just not enough data?

In my 14-year old head, when I was gushing blood from where I had been violated as a nine year old, I was re-traumatized. When the doctor had to give me a shot of testosterone to stop the bleeding, I was terrified. Event after event followed for decades, always transporting me back to the trauma - something I would not wish on anyone.

If you have any thoughts on this topic, please comment below or send me a private message. My hope is that, together, we can raise awareness of this issue so women who experience what I did can get all the help, support and understanding they need.

Dianne Darr Couts,

Advocate, Speaker, Writer

(If you email me, please mention β€œACEs” in the subject line.)


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Hi Dianne, Thanks so much for your comments, thoughts and questions, and being brave enough to share your personal history! It reinforces in my mind why it's so necessary that health care systems should be trained in trauma-informed practices. I recently interviewed a nurse practitioner, Annie Lewis-O'Connor about another project. But she founded and directs the C.A.R.E. clinic at Brigham and Women's Hospital in Boston. It's a trauma-informed clinic that serves girls and women who have experienced sexual assault, domestic violence or have been trafficked. She's also an ACEs Connection member. Perhaps consider reaching out to her.

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