Psychological and endocrine correlates of chronic pelvic pain associated with adhesions
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Patients with chronic pelvic pain and adhesions reported more major life events and showed blunted cortisol responses to CRF stimulation compared to pain-free controls.
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Abstract
Chronic pelvic pain (CPP) is a frequent and often unexplained gynecological complaint. We attempted to evaluate stress history, psychological features and hypothalamic-pituitary-adrenal (HPA) axis function in a group of patients suffering from CPP associated with pelvic adhesions. We recruited 10 patients with CPP and adhesions and 14 painfree, infertile control patients who underwent gynecological examination and diagnostic laparoscopy in a general hospital. Psychological assessment included structured interviews on sexual and physical abuse experiences and major life events as well as questionnaires on pain characteristics and depression. To evaluate HPA axis function, we measured plasma adrenocorticotropin (ACTH) and salivary cortisol responses to the administration of 100 micrograms human corticotropin-releasing factor (CRF). Results revealed high, but not statistically increased, prevalence rates of sexual and physical abuse for patients with CPP and adhesions as compared to controls. Patients with CPP and adhesions reported a significantly higher total number of major life events. Mean depression scores were normal in both groups. Patients with CPP and adhesions demonstrated normal plasma ACTH, but decreased salivary cortisol levels in the CRF stimulation test. These preliminary findings suggest that stress and neuroendocrine changes may also contribute to the pathophysiology of CPP with an identified organic correlate.
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Cited by (9)
- Female Pelvic Pain 2020
- Endometriosis as a Comorbid Condition in Chronic Fatigue Syndrome (CFS): Secondary Analysis of Data From a CFS Case-Control Study 2019
- Early life abuse and risk of endometriosis 2018
- Sexual and physical abuse and gynecologic disorders 2016
- Salivary cortisol concentrations, stress and quality of life in women with endometriosis and chronic pelvic pain 2008
- The Utility of the Beck Depression Inventory in the Evaluation of Chronic Pelvic Pain Patients 2007
- Dor, estresse e qualidade de vida em mulheres com endometriose 2005
- Chronic Pelvic Pain in Men and Women: Pathogenesis, Diagnosis, and Treatment 2004
- Einführung 2003
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