Testifying before the Senate Judiciary Committee, Christine Blasey Ford said a sexual assault from decades ago has continued to define her life.

She said Supreme Court nominee Brett Kavanaugh held her down and groped her at a high school party more than 30 years ago – allegations Kavanaugh has denied – yet she continues to cope with anxiety, post-traumatic stress disorder, claustrophobia and a fear of flying.

Research shows the experience she describes is not unusual. Survivors of sexual violence often experience long-term effects, both physical and mental. A study published Wednesday in JAMA Internal Medicine found that women who experience sexual harassment in the workplace often suffer lasting physical consequences, like elevated blood pressure, while women who have been sexually assaulted are more likely to suffer mental consequences, like persistent symptoms of anxiety and depression. Both groups contend with poor sleep at the level of clinical insomnia.

“The exposures and experiences that can happen to us as young girls and women can have a persistent impact throughout our lives,” said Rebecca Thurston, one of the study authors and a professor of psychiatry at the University of Pittsburgh School of Medicine.

The study doesn’t prove that these incidents cause the health effects, she cautioned, but there is a strong association between experiences of sexual violence and poor health outcomes.

Researchers analyzed data from 304 women between the ages of 40 and 60 – 19 percent of whom had a history of sexual harassment and 22 percent a history of sexual assault. The researchers found that women who had been sexually assaulted were almost three times more likely to have symptoms of major depression and two times more likely to have elevated anxiety.

Women who experienced sexual harassment were twice as likely to have hypertension and three times more likely to have high triglyceride levels. All of these are risk factors for cardiovascular disease, Thurston said, which is the leading cause of death for women.

The findings were consistent even when controlling for factors like age, race, education and medication use. Researchers did not ask when the incidents took place, but national data show that the majority of sexual violence victims were under age 30 when they were attacked.

“This shows we need to not only consider the social and ethical questions of sexual assault and harassment, but also the potential implications for women’s health,” Thurston said.

An estimated 40 percent to 75 percent of women in the U.S. have experienced workplace sexual harassment, and more than one in three women have experienced sexual violence.

The national spotlight on Kavanaugh in recent weeks has brought those memories to the forefront for many survivors. The National Sexual Assault Hotline reported a 338 percent increase in traffic on the day of Ford’s hearing. The day after was the busiest day in the hotline’s 24-year history.

Melanie Sachs, executive director of Sexual Assault Response Services of Southern Maine said last week that calls to the helpline in Maine have been growing for about a year, and she attributes the increase to the #MeToo movement.

Previous research has shown that many survivors of sexual violence endure flashbacks, sleeping problems and emotional detachment. Post-traumatic stress disorder is common, as are depression, substance use disorder and thoughts of suicide.

The newly published study looked at physical effects of sexual violence as well, which are less frequently studied.

Nancy Krieger, a professor of social epidemiology at Harvard University, co-authored a study in 2008 showing that workplace sexual harassment was associated with elevated systolic blood pressure (the top number in a reading) among low-income women. “When I published our study 10 years ago, there was virtually no work on the topic,” Krieger said. “And that hasn’t changed much.”

The new study focuses on a more affluent, mostly white group of women. That might have led the authors to underestimate the prevalence of the issue, Krieger said, since low-income women and women of color report higher rates of sexual harassment.

The findings suggest doctors should be thinking and asking about a variety of factors when it comes to women’s health. “It’s not all about diet and exercise,” Thurston said. “We need to ask about women’s lived experiences. These are critical.”

Just as racism has been shown to affect a variety of health outcomes, Krieger said, sexual harassment could be having the same kinds of effects.

But more research is needed to understand how it works, said Carol Jordan, executive director of the University of Kentucky’s Office for Policy Studies on Violence Against Women. It’s clear that sexual violence affects women’s health, “but there is tremendous complexity in looking at that impact,” she said.

A study she co-authored in 2006 found women who experienced intimate partner violence were more likely to die from breast cancer than other women. The abuse didn’t cause cancer, but abusive partners often restricted women from doctors’ visits. As a result, they were often diagnosed at later stages of cancer, when treatment is less successful.

Understanding that can help doctors and policymakers create better interventions, Jordan said.

For people who have experienced sexual assault or harassment, the findings are even more reason to seek help, Thurston said. “Oftentimes women will dismiss the importance of their experiences and think they’re not severe enough to matter,” she said. “But they really do matter.”

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