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Exposure to sexual trauma in adulthood is perceived as helplessness and loss of control even if sexuality has been defined as a pleasant event before trauma. Feelings of guilt and shame occurring after trauma as well as secondary clinical pictures such as depression, post traumatic stress disorder, and alcoholism are major causes of sexual dysfunction. Also sexual abuse in childhood raises a sense of weakness and perception of inadequacy. These individuals are at risk of developing inappropriate sexual behaviors over time. Indulging in sexual behaviors and thoughts that are evaluate sexuality as a gift or privilege are precursors for these inappropriate behaviors. In addition, the stigmatization caused by feelings of shame and guilt in these children is another cause of sexual problems in the future.
Childhood sexual trauma is associated with negative attitudes about sexuality, lack of sexual satisfaction, orgasmic failure, need for sexual therapy and low self-esteem about sexual attractiveness. Chronic pelvic pain is a significant clinical entity which causes sexual dysfunction in many ways. In studies, the rate of traumatic childhood sexual experiences was found to be over 60% in these patients (N. Leithner, 2006). The difference between patients with chronic pelvic pain and a healthy control group was found to be even greater in terms of the increasing violence of sexual trauma. In a study of 63 patients with chronic pelvic pain, a history of sexual trauma was identified in 64.5% of cases and deficiencies in sexual function were found to be associated with the level of depression in these patients (ME Randolph, 2006).
There are several studies that show that physical and sexual trauma plays a role in the etiology of vaginismus. In a study comparing the childhood and adolescent sexual traumas of patients with vaginismus and dyspareunia and control groups -(each group consisting of 29 patients) childhood sexual trauma was found to be twice as high as the control group in the vaginismus group (Reissing ED, 2003). In the literature there are case reports suggesting that EMDR is effective in cases of vaginismus resulting from childhood sexual trauma.
In studies evaluating the relationship between childhood sexual traumas and a specific sexual dysfunction, aand in studies examining sexual functioning in general, a strong relationship has been found between these two situations. Structural vulnerability and the severity of sexual trauma were also reported to affect this relationship. While childhood sexual trauma is associated with sexual stimulation disorder, orgasmic disorder, vaginismus, dyspareunia and emotional problems about sexuality (sexual guilt, sexual anxiety etc.) in most individuals, high-risk sexual behaviors, characterized by extreme preoccupation with sexuality and uncontrolled sexual relationships, are seen in fewer individuals.
Sexual childhood trauma in men is being reported, recognized and treated less frequently than the actual prevalence. Sexual dysfunction in these individuals was reported to be seen at least five times more than people who have not been exposed to a trauma. In a study of 1793 individuals, exposure to sexual trauma before age 16 has been reported at more than 1/3 of women and about 1/6 of men. In both sexes, especially in women, an association between the presence of childhood sexual trauma and sexual dysfunction has been identified (Najma JM, 2005). Leonard et al. found that problems associated with orgasm are the most frequent sexual problems seen in individuals who were exposed to a childhood sexual trauma (2008).