This can even include physical effects that many might think of, such as the Joyful Heart Foundation's statements: "Chronic fatigue, shortness of breath, muscle tension, involuntary tremors, changes in eating and sleeping habits. problems related to the menstrual cycle or fertility, and sexual dysfunction.” Some physical problems cannot simply be repaired by women themselves, so they may sometimes need to seek medical attention when people are victims of domestic violence and it leaves injuries that are costly. The United States spends approximately $4.1 billion on “medical and mental health services” annually (quoted in Klap 579). Works cited by Acevedo, Bianca P et al. “Predictors Of Intimate Partner Violence In A Sample Of Multiethnic Urban Young Adults Journal Of”. Interpersonal Violence 28.15 (2013): 3004-3022. MEDLINE with full text Web. October 27, 2014. Gellert, George A. and Frank Keating answering questions about the epidemic destroying American homes and communities. 2nd ed. Washington, DC: American Public Health Association, 2002. Print. Klap, Ruth et al. “Domestic Violence Screening Among Adult Women in the United States.” Journal of General Internal Medicine 22.5 (2007): 579-584. MEDLINE with full text. Internet. October 27, 2014. Rennison, Callie Marie, Walter S. DeKeseredy and Molly