taking care of your health

Having been raped or sexually assaulted you might feel that you have suffered a loss of power and control over your body and life. One way of beginning to take back some of this control is by taking care of your health.

Injuries

If you have serious juries such as bruising or bleeding then you can visit the Accident and Emergency Department of your local hospital for immediate treatment. You do not have to give anyone details of what happened to you if you do not want to - even though you may be asked to do so. If, for example, you have severe vaginal bleeding (heavier than a period and continuous) then go straight to hospital. If you are bleeding you will need to tell the hospital what has happened or they may not be able to treat you effectively.

Any cuts and tears are best treated quickly. If you are suffering from pain and/or bleeding then you should try and see a doctor as soon as possible. If you have a doctor that you particularly then like it is worth visiting her or him if you have only slight injuries; however, doctors may refer you to the local casualty department if they consider that stitches are required.

If you have reported the assault to the police then you may have already had an examination by a police surgeon. This is only to collect forensic evidence and is not a medical check-up, so you may still need to have another check up if you need treatment for any injuries or infections.

Sexually Transmitted Infections

Apart from getting treatment for bruising, cuts, or other injuries it is important to be aware of the physical effect of rape and the possible effects on your body. It might be very difficult to think about it immediately, but if you have been raped vaginally then pregnancy and contracting a sexually transmitted illness (STI) is a possibility. By knowing what is going on in your body it can enable you to begin to take back control over it.

Some STI's are not always obvious without a medical check-up. Infections can be caught by sexual contact vaginally, genitally, anally, or orally with a man who has the infection. If you catch a sexually transmitted infection then this is entirely because the rapist has one. Getting an STI from being raped has nothing to do whether you have had sex before or not, or how many times, or with how many people. It is nothing to feel ashamed or embarrassed about.

Symptoms often appear similar for different infections and include - pain on passing urine, vaginal discharge, lower abdominal pain, pelvis pain, itching, soreness, and painful lumps or warts in the genital area. For more details of all various infections and STI's we suggest going to specific services that specialise in sexual health.

It is common to have an infection and show no symptoms as all for some time. Do not wait for symptoms to appear before having tests. It is, of course, extremely upsetting to find you have an STI. Being raped can leave you feeling dirty anyway and finding you have an infection can make this feel much worse. Starting an effective course of treatment as soon as possible is one of the best ways to address this.

Additionally, although the numbers of documented cases are small, HIV and other sexually transmitted infections through rape and sexual assault can infect women and children. Physical violence is often associated with rape and sexual assault and can therefore involve damage to oral, genital, vaginal and rectal tissue - it is here that technically the facilitation or transmission of HIV and other STI's such as Chlamydia, Hepatitis, and Genital Wart virus can happen.

This is why it is important to visit a specialist clinic immediately or as soon as you are able. Try to take someone to support you when you attend a clinic; and women counsellors or clinicians should also be available at the clinic.

If you are also worried about the possibility of minor injuries - vaginal or anal tears for example, then the department in the hospital called the Genito-Urinary Medicine Clinic (also known as the GUM Clinic, or Special Clinic) should be able to help you. At the clinic all the information is kept confidential. You do not have to give your name, address, doctor's name, or the details of the assault, even though you may be asked to do so. The clinic will be able to test for many infections including HIV and they will be able to offer you a smear test (a test which can show up any changes in the cells on the neck of the womb). There should be no pressure to report to the police.

At the clinic you can be offered preventative treatment for oral and reproductive infections. Emergency contraception can also be taken to prevent unwanted pregnancy and you can get information about an abortion referral. Any infection can be easily treated if detected quickly, but if left untreated some STI's can cause serious internal damage. You cannot wait and see if symptoms appear and assume that if there are not any, then there is no infection. Some STI's show no symptoms until a fairly late stage.

If possible do try to attend any follow up appointments at clinics for test results. Some results can be given over the phone, but some such as HIV will only be offered to you personally as counselling before and after the testing will normally be offered.

Myth

STI's are often associated with promiscuity and many women are made to feel embarrassed or ashamed for having such an infection or even admitting it as a possibility even when they have not chosen to have intercourse. There are frightening myths about these illnesses being incurable or even making you mad. These are not true and these myths only exist because of the taboo around STIs and because of people's fear and ignorance. In fact many commonly sexually transmitted infections are bacterial infections and are easily treated with a course of anti-biotics (in the same way that tonsillitis would be treated).

Pregnancy

If there is a chance you might be pregnant as a result of the rape then you may need to speak to a Doctor. You can arrange to see your Doctor or contact your local Family Planning Clinic. You can consider using the Emergency of Morning After Pill, but treatment needs to start within 72 hours of the assault. Again you will need to contact your Doctor or your local Family Planning Clinic (FPC). You can talk to a counsellor at your nearest Rape Crisis Centre who will support you in accessing services.

If you are pregnant and considering an abortion then contact your Doctor, your local FPC for a National Health abortion, or the British Pregnancy Advisory Service for an private abortion. You may find your periods become irregular after the assault and this may be due to shock and stress, but it is always worth getting things checked out.

Give yourself permission to really take care of your health and be aware of longer-term general health problems. All of these can be seen as a result of the experience itself, but neglecting your well-being can eventually become quite self-destructive. If you seek medical or mental health support, the practitioner should respect the connection between ill health and sexual violence. Prescribed drugs can give temporary relief from insomnia or depression, but it is important not to 'cut off' from your feelings permanently as this may lead to long-term depression.