• Dyspareunia, Vulvodynia (See also Loss of Libido)
• Loss of Libido (See also Dyspareunia, Vulvodynia)
• Sexually Transmitted Diseases (STD) - Pelvic Inflammatory Disease
• Sexuality, Sex Education
• Birth Control, Contraception
• Abusive Relationships - dating, marriage, workplace (see also Rape, Date Rape, Acquaintance Rape)
• PAP Tests

Most Americans have some memory of the Vietnam war and the scars it left on the soldiers who were there, formed both from the brutality of the combat and also in the return home, often without honor. It was during this era that we saw some recognition of a syndrome called "Post Traumatic Stress Disorder" or PTSD. Trauma, such as fighting in a brutal war and returning home without honor, is an event which is not commonly experienced in everyday life. When such an event is very disturbing to the individual (partially based on the person’s response to the trauma), then PTSD can occur. Previous life experience, personality coping mechanisms and availability of support systems (as well as the intensity of the event) are what determine if PTSD will occur after a traumatic event.

Can women experience PTSD? Certainly they can. While combat is, perhaps, the most common reason for a man to experience this - Rape has a similar impact on a woman. Other factors that can, and do, put women at risk for developing PTSD include loss of a loved one, a serious accident, violent crime, a natural disaster, or ongoing physical or emotional abuse. Post traumatic stress may be seen more frequently in people who are single, divorced, widowed, poor, or socially isolated.
The symptoms of PTSD can be nearly as frightening as the original event, especially if the person is unaware of the syndrome and does not seek the appropriate help and support. The symptoms can include:

• Persistent and painful re-experiencing of the event, either through nightmares (while asleep) or flash backs (while awake).
• Emotional numbness or a difficulty in expressing emotions to friends or loved ones.
• Avoiding any reminders of the event.
• Being on edge or easily startled.
• Having a difficult time making plans for one’s life.
• Various physical symptoms, including pelvic pain occurring without other causes.

In my own life, I experienced PTSD after a prolonged battle against cultural discrimination which eventually ended in a painful loss of almost everything I had once loved. While my symptoms were fairly mild, I recognize that I was more at-risk for this because I had a similar traumatic experience with discrimination as a young child in grade school. My sister was handicapped and, in our small town, I often caught the brunt of the painful treatment we both received from our classmates. I firmly believe that I got the strength and determination to fight the cultural discrimination I experienced as an adult (which benefited the entire community) from my childhood survival of similar trauma. At the same time, because of my childhood encounter, I also can see that experiencing similar issues again as an adult did intensify the pain at times. Being divorced, I fully believe I was seen as an easier target and, also, had less (financial) supports to fall back on when the rug finally was pulled out from under me. I had learned (perhaps from my childhood experience) how to maximize the existing supports and this, I believe, was key in my own long-term success and recovery.

In my own case, I experienced an incredible feeling of impending doom (this lasted several months), joint aches (perhaps an immune response from feeling "rejected"), vivid nightmares about the loss, and a difficulty in making future plans for my life. My symptoms were mild compared to what some people experience, and yet were a real wake-up call for me as a healthcare professional, to the serious impact PTSD can have on our lives.

In my own clinical practice as a nurse-midwife, I see PTSD issues for women surface most commonly after rape, incest, abuse or loss of a child/pregnancy. I deal mostly with at-risk, low income women with few supports and frequently some childhood history of trauma. Because of my own experience with PTSD, I now believe that this reaction to severe trauma may be more common in women than most people realize.

What can a woman do if she believes she is experiencing PTSD or is at risk? Early recognition and treatment is the most effective approach I have found. (Remember, sometimes the symptoms don’t surface until long after the trauma.) Early treatment includes quickly recognizing and acknowledging the traumatic event, talking about your feelings soon after the event, and being reassured that what you are feeling is normal. From my own experience, I would also say that recovery is not an overnight process. There are times even years later when something will serve as a trigger to remembering the trauma. At these times, it is wise to seek out support systems which allow the woman to talk freely about her feelings without being told "it is in the past" or "just move on".

Trauma heals only from talking about it openly with those who understand and can support. I recommend women who believe they may have PTSD to seek counseling early, to look for support groups (there are some excellent ones on the web) and to find those friends who are willing to listen and support as the deep wounds heal. In time and with proper healing, experiencing such deep trauma can and does lead to us being even stronger human beings who will reach out to help others.