Instances of sexual harassment and assault have been gaining (long overdue) visibility, but we don’t often hear about the longterm effects on survivors. Sexual harassment and assault can have a dangerous impact on survivors’ mental health, and now, a new study suggests they can affect survivors’ physical health as well.

In the study, published in JAMA Internal Medicine today, October 3rd, researchers assessed the mental and physical health of 304 non-smoking women aged 40-60 who had originally enrolled in a menopause study. Out of the study’s participants, 19% said they had been sexually harassed at work, and 22% said they had been sexually assaulted. The study did not distinguish between recent, ongoing, and past incidents.

The researchers found that women who had experienced sexual harassment were twice as likely to have high blood pressure as women who had not. Meanwhile, women who had been sexually assaulted were three times more likely to suffer from depression and twice as likely to have symptoms of anxiety compared to women who had never been assaulted. Both sexual assault and harassment had a negative effect on sleep quality as well; survivors from both groups were twice as likely to have trouble sleeping, which, as the study’s authors noted, can cause further negative health effects.

Rebecca Thurston, a psychiatry professor at the University of Pittsburgh and one of the study’s authors, told USA Today that since the study excluded those who smoke or who were already taking medications for depression or anxiety, the percentage of women with health issues as a result of past harassment or assault might be larger among the general population.

While we already knew that sexual harassment and assault negatively affects survivors, this study reinforces the fact that we need to make sexual harassment and assault things of the past. Time is seriously up.