Abuse History More Common in Those With Pelvic Pain, CFS, and Fibromyagia

Although the research findings are mixed, I have found a history of abuse to be common in my CFS/FMS patients. In one study, exposure to childhood trauma was associated with a 6-fold increased risk of CFS and this was associated with the stress hormone changes seen in CFS (see abstract below). And as many as 70% have suffered physical or emotional abuse — as opposed to 15% of healthy people and 45% of those with other rheumatologic problems.¹ In another study, 18-33% of patients with Interstitial Cystitis had a history of sexual abuse.²

We have also seen in our practice that the pelvic pain is sometimes associated with hysterectomy at a young age associated with a history of childhood sexual abuse, with the psyche seemingly trying to create a "clean sweep" of the pelvic area surgically.

Meanwhile, physicians continue this abuse pattern by invalidating and not adequately addressing the medical problems that can occur downstream from abuse issues, and dismissing women with these severe processes like they are crazy. It is like dismissing people with crushing chest pain and a massive heart attack like they are crazy because hostility and depression are associated with an increased heart attack risk.

Whether or not associated with a history of abuse, or whether or not CFS/FMS are also present, pelvic pain can be a major problem, and deserves to be addressed. So whether it is vaginal pain (e.g., vulvodynia) or bladder pain (e.g., interstitial cystitis), here is information on pelvic pain in women that can help ease the pain.

Study Abstract

Childhood Trauma and Risk for Chronic Fatigue Syndrome: Association With Neuroendocrine Dysfunction

Journal: Arch Gen Psychiatry. 2009;66(1):72-80
Authors: Christine Heim, PhD; Urs M. Nater, PhD; Elizabeth Maloney, MS, DrPH; Roumiana Boneva, MD, PhD; James F. Jones, MD; William C. Reeves, MD, MSc
Author Affiliations: Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine (Drs Heim and Nater), and Chronic Viral Diseases Branch, National Center for Zoonotic, Vector-borne, and Enteric Diseases, Centers for Disease Control and Prevention (Drs Nater, Maloney, Boneva, Jones, and Reeves), Atlanta, Georgia

Context

Childhood trauma appears to be a potent risk factor for chronic fatigue syndrome (CFS). Evidence from developmental neuroscience suggests that early experience programs the development of regulatory systems that are implicated in the pathophysiology of CFS, including the hypothalamic-pituitary-adrenal axis. However, the contribution of childhood trauma to neuroendocrine dysfunction in CFS remains obscure.

Objectives

To replicate findings on the relationship between childhood trauma and risk for CFS and to evaluate the association between childhood trauma and neuroendocrine dysfunction in CFS.

Design, Setting, and Participants

A case-control study of 113 persons with CFS and 124 well control subjects identified from a general population sample of 19 381 adult residents of Georgia.

Main Outcome Measures

Self-reported childhood trauma (sexual, physical, and emotional abuse; emotional and physical neglect), psychopathology (depression, anxiety, and posttraumatic stress disorder), and salivary cortisol response to awakening.

Results

Individuals with CFS reported significantly higher levels of childhood trauma and psychopathological symptoms than control subjects. Exposure to childhood trauma was associated with a 6-fold increased risk of CFS. Sexual abuse, emotional abuse, and emotional neglect were most effective in discriminating CFS cases from controls. There was a graded relationship between exposure level and CFS risk. The risk of CFS conveyed by childhood trauma further increased with the presence of posttraumatic stress disorder symptoms. Only individuals with CFS and with childhood trauma exposure, but not individuals with CFS without exposure, exhibited decreased salivary cortisol concentrations after awakening compared with control subjects.

Conclusions

Our results confirm childhood trauma as an important risk factor of CFS. In addition, neuroendocrine dysfunction, a hallmark feature of CFS, appears to be associated with childhood trauma. This possibly reflects a biological correlate of vulnerability due to early developmental insults. Our findings are critical to inform pathophysiological research and to devise targets for the prevention of CFS.

References

¹Castro I, Barrantes F, Tuna M, Cabrera G, Garcia C, Recinos M, Espinoza LR, Garcia-Kutzbach A. Prevalence of Abuse in Fibromyalgia and Other Rheumatic Disorders at a Specialized Clinic in Rheumatic Diseases in Guatemala City. Clin Rheumatol. 2005 Jun;11(3):140-145.

²J Urol. 2008 Nov; 180(5):2029-33 10.1016/j.juro. 2008.07.053