Psychological factors - endometriosis

[Violet M]

Just wondering why there would be a study on psychological factors in pain due to endometriosis. Would love to hear comments from women with endometriosis.

http://www.ncbi.nlm.nih.gov/pubmed/21606636

Gynecol Obstet Invest. 2011 May 21.
Psychological Factors in Chronic Pelvic Pain due to Endometriosis: A Comparative Study.
Roth RS, Punch M, Bachman JE.
Source
Department of Physical Medicine and Rehabilitation, University of Michigan Health System, Ann Arbor, Mich., USA.
Abstract
Background/Aims: This study compared women suffering chronic pelvic pain (CPP) secondary to endometriosis (n = 30) with women experiencing CPP due to either myofascial abdominal/pelvic pain (n = 70) or pelvic adhesions (n = 38) to determine if there are specific psychological variables uniquely associated with endometriosis. Methods: This is a cross-sectional study of 138 women drawn from a convenience sample of 192 consecutive women with CPP presenting for evaluation to a university hospital chronic pain clinic. Subjects were categorized into groups based on their CPP diagnosis. Each subject completed a battery of validated inventories assessing demographic status, pain experience and other pain-related symptoms, pain disability, frequency of depressive symptoms, level of affective distress, satisfaction with pain treatment and satisfaction with their marital relationship. Results: No differences were obtained across the three groups for any of the outcome measures. Effect size computation supported the absence of clinical differences across the groups for these measures. Conclusion: These findings fail to support the presence of a unique psychological profile or disproportionate psychological disturbance for women with CPP due to endometriosis. These data illustrate the importance of considering control groups that include chronic pain when exploring psychological contributions to specific chronic pain conditions.

Copyright © 2011 S. Karger AG, Basel.

PMID: 21606636 [PubMed - as supplied by publisher]

[Lernica]

Just wondering why there would be a study on psychological factors in pain due to endometriosis. Would love to hear comments from women with endometriosis.

Good question. Maybe because many women with endo do not experience pain, only discovering that they have the disease after having trouble conceiving? Endo is a very mysterious disease with different pain outcomes that do not co-relate with the severity of the disease as visualized during laparoscopy. But I've NEVER heard of a psychological component being the reason for different pain levels among women with the disease.

Violet, thank you for all your great posts on current literature about pelvic pain. You rock!

[Violet M]

Lernica, I was browsing through scholarly articles on chronic pelvic pain and was dismayed at how many of the studies had something to do with the pscyhologic aspects. Why is there such a stigma associated with CPP as compared to most other illnesses?

[helenlegs 11]

I'm not an endo sufferer but saw this

Also, endometriotic lesions can develop their own nerve supply, thereby creating a direct and two-way interaction between lesions and the central nervous system, potentially producing a variety of individual differences in pain that can, in some women, become independent of the disease itself.[3]

We all know how many PN'ers have been told 'it's all in their heads' with 'the look' or even referred for pyschiatry because the normal imaging techniques can't show nerves. My pain is because of scar tissue/lesions forming around my nerves . . . . thats just a double whammy nerves forming inside lesions. . . .
Could some of the disbelief come from the fact that it's 'woman's problems' ? ? ?
I know that I will mention the fact that male PN patients can suffer from scrotum and penile pain and ER at my disability tribunal in July in an attempt to get the all male board to take notice and parhaps relate.
Will have to practise saying scrotum out loud, Just got the hang of talking about my vagina to people I don't even know
take care
Helen

[Karyn]

I know that I will mention the fact that male PN patients can suffer from scrotum and penile pain and ER at my disability tribunal in July in an attempt to get the all male board to take notice and parhaps relate.
Will have to practise saying scrotum out loud,

You are too cute with your !

Just got the hang of talking about my vagina to people I don't even know

Oh, I know it!!! Me, too!

But I've NEVER heard of a psychological component being the reason for different pain levels among women with the disease.

Me, either.
I was diagnosed with endo prior to my hysterectomy. This was an accepted, "rational" cause for my pelvic pain. It wasn't until I actually had the hysterectomy that I became a psychological supspect. NO endo. Just a big, fat uterus the size of bowling ball loaded with fibroids and folding in on itself. Now, I'm a head case: "Fibroids wouldn't cause that"...

[Charlie]

Why is there such a stigma associated with CPP as compared to most other illnesses?

It might be because as far back as ancient Greece there has been a belief that there is an intimate connection between pelvic organs and the mind. In ancient Greece it was believed the female uterus sometimes became displaced, and wandered through the body, negatively influencing the brain. Beliefs based around this view persisted for a considerable time. Up until the 19th century hysterectomies were being performed to cure hysteria. Which explains the name of the operation. The reason the root word "hyster" refers to the womb is derivative of the word "hysteria" based on the sexist assumption that the womb itself caused uncontrollable, emotional behavior.

So it is no surprise that pelvic pain is sometimes erroneously assumed to be of psychological origin.

Having said that I think many other medical conditions are attributed to be of psychological origin. You can hire life coaches now to help you beat cancer. For instance look at the quote I found on this website.

There are certain characteristics and personality traits that seem to be more prominent in those prone to cancer. Their common theme is a lack of personal respect or care, or self nurturing, or self loving. These characteristics include helping others to the detriment of them selves – denying there own needs due to believing that others must come first; the inability to express negative feelings, especially those of anger, shame or fear; long held resentment or guilt, often from childhood, that may have never been expressed; a sense of powerlessness, as when another person is emotionally stronger or more dominating; feeling worthless, unimportant, or not good enough; and an inner hopelessness leading to what has been termed “acceptable suicide”.

http://www.iempowerself.com/55_cancer_ailments.html

So it is n't just pelvic pain. For years patients were told that that stomach ulcers were caused by stress or spicy foods and then it was discovered that they were caused by a bacteria called Helicobacter pylori.

There is clearly a psychological component to pain but in my view it is a mistake to leap to the conclusion that it is caused by it.

[Celeste]

I'd like to see one of these researchers get sacked by CPP and have even one provider play the emotion card on them. It would be an AHA Moment extraordinaire.

[Lernica]

Also, endometriotic lesions can develop their own nerve supply, thereby creating a direct and two-way interaction between lesions and the central nervous system, potentially producing a variety of individual differences in pain that can, in some women, become independent of the disease itself.[3]

Wow! I didn't know that, Helen! Is there a published paper to this effect?

[Lernica]

Up until the 19th century hysterectomies were being performed to cure hysteria. Which explains the name of the operation. The reason the root word "hyster" refers to the womb is derivative of the word "hysteria" based on the sexist assumption that the womb itself caused uncontrollable, emotional behavior.

Unbelievable!!! I'd like to say we've come a long way but I hesitate to in light of the publications about the psychological components of CPP that Violet has referred to!

[Karyn]

In ancient Greece it was believed the female uterus sometimes became displaced, and wandered through the body, negatively influencing the brain. Beliefs based around this view persisted for a considerable time. Up until the 19th century hysterectomies were being performed to cure hysteria. Which explains the name of the operation. The reason the root word "hyster" refers to the womb is derivative of the word "hysteria" based on the sexist assumption that the womb itself caused uncontrollable, emotional behavior.

How do we go about changing the name of this procedure?????

I'd like to see one of these researchers get sacked by CPP and have even one provider play the emotion card on them. It would be an AHA Moment extraordinaire.