Research Article

Association between the victim’s menstrual cycle phase and genital injuries following sexual assault

Annie Vu, Victoria Moaddel, Bradley Emmerich, Linda Rossman, Jennifer Bach, Jason Seamon, Mariah Barnes, Lindsey Ouellette and Jeffrey Jones*

Published: 02 May, 2023 | Volume 6 - Issue 2 | Pages: 038-042

Background: It is unknown what effect the menstrual cycle can have on the susceptibility to trauma following sexual assault. 
Objectives: To compare the incidence of genital injuries following sexual assault in women with relationship to the three phases of the menstrual cycle
Methods: The design was a retrospective, cohort analysis set in a community-based nurse examiner program over a five-year study period. Sexual assault victims were between the ages of 13 - 40 years and agreed to a forensic examination. The menstrual cycle was divided into three phases: follicular, luteal and menses phase. The primary outcomes were the frequency and type of genital injuries documented in relation to the different phases of the menstrual cycle.
Results: Case files of 1376 cases of sexual assault were reviewed; 682 (49.6%) met the inclusion criteria. A total of 220 victims (32.3%) were in the follicular phase, 361 (52.9%) were in the luteal phase and 101 (14.8%) were in the menses phase. The three groups were comparable in terms of demographics, assault characteristics, and overall frequency of non-genital injuries. Assault victims in the follicular phase of the menstrual cycle had significantly more documented genital injuries (72.3%; 95% CI 66.4 - 78.2) compared to the luteal phase (64.0%; 95% CI 59.0 - 68.9) and the menses phase (58.4%; 95% CI 48.8 - 68.0). 
Conclusion: Forensic examiners documented more genital injuries in the follicular phase of the menstrual cycle. Sex hormones may have confounding effects through influences on vaginal epithelial and mucosal integrity.

Read Full Article HTML DOI: 10.29328/journal.cjog.1001127 Cite this Article Read Full Article PDF


Sexual assault; Menstrual cycle; Follicular phase; Genital injuries; Epidemiology


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