North Korean officials commit sexual abuse against women with near total impunity, according to a report from rights group Human Rights Watch (HRW).
HRW said such abuse is so common it has become part of ordinary life.
The report is based on interviews with 62 North Koreans who fled the country and provided detailed accounts of rape and sexual abuse.
The group said it revealed a culture of open, unaddressed abuse, particularly from men in positions of power.
"They consider us [sex] toys. We are at the mercy of men," Oh Jung-hee, a former trader in her 40s told the report's authors.
"Sometimes, out of nowhere, you cry at night and don't know why."
Gathering information from inside the secretive state is extremely difficult and reports like this are rare.
'My life was in his hands'
According to HRW some women said that sexual abuse had become so normalised that they did not think it was "unusual" - with some saying it had become accepted as part of everyday life.
A lack of sexual education and an unchecked abuse of power by the perpetrators were some of many factors that has led to this mentality, the report added.
Perpetrators include high-ranking party officials, prison facility guards, police and soldiers.
Interviewees told the group that when an official "picked" a woman, she would have little choice but to comply.
This happened to one woman, who was being questioned by a police official in a pre-trial detention facility, after she was caught fleeing North Korea.
"He made me sit very close to him... [and] also touched me between the legs ...several times during different days," said Park Young-hee.
"My life was in his hands, so I did everything he wanted. How could I do anything else?"
HRW called for North Korea to "acknowledge the problem of sexual violence" and ensure that it was "treated as a crime".
A UN Report in 2014 had earlier concluded that "systematic, widespread and gross human rights violations" had been committed by the North Korean government.
It added that forced abortion, rape and sexual violence had been carried out in prisons or in detention.