Many adults who suffered childhood sexual abuse experience unexplained physical health problems like stomach pain, headaches, fatigue, and migraines. The cause of these symptoms was long unclear. Over the past 30 years, research has linked childhood sexual abuse to many adult health problems, with similar findings across countries and study types.

What the Research Shows

A 2009 JAMA meta-analysis of 23 studies with over 4,000 participants focused on sexual abuse. It found survivors had higher rates of GI conditions like irritable bowel syndrome, chronic pelvic pain, and fibromyalgia, which causes pain throughout the body (Paras et al., 2009). In 2019, Oxford and King’s College London researchers published a review in The Lancet Psychiatry, pooling 19 meta-analyses, over four million participants, and 28 long-term outcomes of childhood sexual abuse. Survivors faced 40% to 90% higher risk for physical conditions like obesity and HIV (Hailes et al., 2019).

Health Conditions Linked with CSA

Survivors have higher rates of the following conditions:

Diabetes. A study of nearly 22,000 Canadian adults found that the risk of adult type 2 diabetes rose with the severity of abuse, about 16% higher odds for unwanted touching, 34% higher for a single episode of forced sex, and 69% higher for repeated forced sexual abuse (Shields et al., 2016).

Obesity. A 2014 meta-analysis pooled 23 studies and more than 112,000 participants. Childhood sexual abuse was linked with about 31% higher odds of adult obesity; severe childhood abuse of any kind was linked with about 50% higher odds (Hemmingsson et al., 2014).

Cardiovascular disease. In a long-term study of women in the Nurses’ Health Study II, those who experienced forced sex in childhood or adolescence had a 56% higher risk of heart attack and stroke in adulthood, compared with women who had not been sexually abused (Rich-Edwards et al., 2012).

Chronic pain. Survivors have higher rates of fibromyalgia, chronic pelvic pain, and unexplained gut pain, including irritable bowel syndrome. In studies of rape survivors, women had more than three times the odds of fibromyalgia compared with women without that history (Paras et al., 2009).

Migraine. Childhood sexual abuse, especially when it happened before age 12, has been linked with migraines that come alongside major depression. This combination tends to be more severe and harder to treat than migraine alone (Tietjen et al., 2007).

Endometriosis. Endometriosis is a condition in which tissue like the lining of the uterus grows outside it, often causing severe pelvic pain. A long-term study of more than 60,000 women in the Nurses’ Health Study II found that childhood sexual abuse was linked with about 15% higher risk of endometriosis. The risk rose with the severity and chronicity of abuse, and was highest in women who experienced severe, chronic abuse of multiple types, 79% higher than in women without an abuse history (Harris et al., 2018).

Pelvic floor dysfunction. Pelvic floor disorders affect bladder, bowel, and sexual function. In a study of midlife women, childhood sexual abuse was linked with higher rates of all three (Dugan et al., 2023).

Cancer. A 2021 meta-analysis of 18 studies and more than 400,000 participants found that survivors of childhood sexual abuse had about 26% higher odds of an adult cancer diagnosis (Hu et al., 2021). A 2026 PLOS One study of older Canadians reported a stronger link, about twice the odds of cancer, even after accounting for smoking, income, and other health conditions (Langiano et al., 2026).

Chronic lung disease. A study of more than 3,000 women in Hawaii found that childhood sexual abuse was linked with about 74% higher odds of chronic obstructive pulmonary disease (COPD). The link was only partly explained by smoking (Remigio-Baker et al., 2015).

Sexually transmitted infections. A study that followed 754 people for 30 years found that survivors of childhood sexual abuse had nearly twice the odds of being diagnosed with a sexually transmitted infection as adults, and more than three times the odds of being diagnosed with more than one (Wilson & Widom, 2009).

Why These Effects Occur

Researchers have identified several biological pathways that probably work together.

Long-term changes to the stress system. The body’s stress response is designed for short-term danger. Repeated threats during childhood can keep this response activated for years, with ongoing release of stress hormones. Over time, this can wear on many organ systems.

Chronic inflammation involves the body’s response to infections and injuries. Studies show that adult survivors have elevated inflammatory levels, which have been linked to damage to blood vessels, organs, and DNA (Bertone-Johnson et al., 2012).

Accelerated cellular aging occurs when telomeres, protective caps on chromosomes, shorten more quickly. A study of over 3,200 people linked severe childhood sexual abuse to shorter telomeres in adulthood, indicating faster cell aging (Warner et al., 2020).

Behavioral pathways. Some survivors develop coping behaviors like smoking, drinking, disordered eating, and poor sleep, affecting long-term health. These are responses to ongoing distress, not isolated choices.

What This Means for Care

The research has direct implications for medical care and prevention. For survivors, it affirms that physical symptoms have a real biological basis. For clinicians, it supports routinely asking patients about adverse childhood experiences and offering trauma-informed care. The findings also support prevention. Preventing childhood sexual abuse reduces immediate harm and lowers the risk of these long-term health problems.

References

Bertone-Johnson, E. R., Whitcomb, B. W., Missmer, S. A., Karlson, E. W., & Rich-Edwards, J. W. (2012). Inflammation and early-life abuse in women. American Journal of Preventive Medicine, 43(6), 611–620.

Dugan, S. A., Karavolos, K., Zhang, Y., Avery, E., Janssen, I., Farhi, M., Harlow, S. D., & Kravitz, H. M. (2023). Childhood sexual abuse and pelvic floor dysfunction in midlife women in the Study of Women’s Health Across the Nation. Journal of Women’s Health, 32(3), 293–299.

Hailes, H. P., Yu, R., Danese, A., & Fazel, S. (2019). Long-term outcomes of childhood sexual abuse: An umbrella review. The Lancet Psychiatry, 6(10), 830–839.

Harris, H. R., Wieser, F., Vitonis, A. F., Rich-Edwards, J., Boynton-Jarrett, R., Bertone-Johnson, E. R., & Missmer, S. A. (2018). Early life abuse and risk of endometriosis. Human Reproduction, 33(9), 1657–1668.

Hemmingsson, E., Johansson, K., & Reynisdottir, S. (2014). Effects of childhood abuse on adult obesity: A systematic review and meta-analysis. Obesity Reviews, 15(11), 882–893.

Hu, Z., Kaminga, A. C., Yang, J., Liu, J., & Xu, H. (2021). Adverse childhood experiences and risk of cancer during adulthood: A systematic review and meta-analysis. Child Abuse & Neglect, 117, 105088.

Langiano, M. R., Malfitano, C., & Fuller-Thomson, E. (2026). Casting a long shadow: Exploring the link between childhood maltreatment and cancer in adulthood. PLOS One, 21(4), e0345411.

Paras, M. L., Murad, M. H., Chen, L. P., Goranson, E. N., Sattler, A. L., Colbenson, K. M., Elamin, M. B., Seime, R. J., Prokop, L. J., & Zirakzadeh, A. (2009). Sexual abuse and lifetime diagnosis of somatic disorders: A systematic review and meta-analysis. JAMA, 302(5), 550–561.

Remigio-Baker, R. A., Hayes, D. K., & Reyes-Salvail, F. (2015). Adverse childhood events are related to the prevalence of asthma and chronic obstructive pulmonary disorder among adult women in Hawaii. Lung, 193(6), 885–891.

Rich-Edwards, J. W., Mason, S., Rexrode, K., Spiegelman, D., Hibert, E., Kawachi, I., Jun, H. J., & Wright, R. J. (2012). Physical and sexual abuse in childhood as predictors of early-onset cardiovascular events in women. Circulation, 126(8), 920–927.

Shields, M. E., Hovdestad, W. E., Pelletier, C., Dykxhoorn, J. L., O’Donnell, S. C., & Tonmyr, L. (2016). Childhood maltreatment as a risk factor for diabetes: Findings from a population-based survey of Canadian adults. BMC Public Health, 16, 879.

Tietjen, G. E., Brandes, J. L., Digre, K. B., Baggaley, S., Martin, V. T., Recober, A., Geweke, L. O., Hafeez, F., Aurora, S. K., Herial, N. A., Utley, C., & Khuder, S. A. (2007). History of childhood maltreatment is associated with comorbid depression in women with migraine. Neurology, 69(10), 959–968.

Warner, E. T., Zhang, Y., Gu, Y., Taporoski, T. P., Pereira, A., DeVivo, I., Spence, N. D., Cozier, Y., Palmer, J. R., Kanaya, A. M., Kandula, N. R., Cole, S. A., Tworoger, S., & Shields, A. (2020). Physical and sexual abuse in childhood and adolescence and leukocyte telomere length: A pooled analysis of the study on psychosocial stress, spirituality, and health. PLOS One, 15(10), e0241363.

Wilson, H. W., & Widom, C. S. (2009). Sexually transmitted diseases among adults who had been abused and neglected as children: A 30-year prospective study. American Journal of Public Health, 99(Suppl 1), S197–S203.