(PNM-44) Physiotherapeutic assessment of women with a history of sexual violence attended in a public sexology outpatient clinic: a case series

Abstract Objective To analyze the physiotherapeutic assessment of women with a history of sexual violence (SV) treated at a multidisciplinary public sexology outpatient service. Methodology Cross-sectional, descriptive study based on the records of 10 women with SV history treated between January/2021 and May/2025. Data were analyzed using REDCap software. Results Participants aged 31-55 years (mean 42); all cisgender heterosexual women; two were not in relationships. Sexual complaints included impaired spontaneous desire (5), impaired responsive desire (5), difficulty or inability to achieve orgasm (8) and all reported some form of dyspareunia. In terms of body awareness, five reported difficulty, while four identified their erogenous zones. Regarding masturbation, five had never engaged in it, three of whom reported religious taboos. Physical exam revealed trophic vulvas in seven patients and atrophy in two. On sensory assessment, two showed decreased sensitivity, but the cutaneo-anal and bulbocavernosus reflexes were present in all. Perineal awareness was present on the first attempt in five, second attempt in two, absent in two. Hypertonic pelvic floor muscles found in seven. PERFECT test showed good contraction ability in all, with accessory muscle use observed in four. Muscle relaxation was partial in five women, complete in two, and absent in one. The perineal body was hypertonic in five, hypotonic in three, and normotonic in one. All participants reported pain in vaginal palpation, most commonly in bulbospongiosus, ischiocavernosus, and puborectalis muscles. Conclusion There is a significant correlation between a history of SV and pelvic floor dysfunction. Traumatic and violent sexual experiences can persist throughout life, lasting imprints on perceptions of sexuality and pain during sexual activity. Addressing personal, psychological, and sociocultural aspects is essential when developing a comprehensive therapeutic approach to sexuality. Financing No conflict.