Psychological and endocrine correlates of chronic pelvic pain associated with adhesions

Christine Marcelle Heim, U. Ehlert, J. P. Hanker, D. H. Hellhammer

Research output: Contribution to journalArticle

24 Citations (Scopus)

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 μg 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.

Original languageEnglish (US)
Pages (from-to)11-20
Number of pages10
JournalJournal of Psychosomatic Obstetrics and Gynaecology
Volume20
Issue number1
DOIs
StatePublished - Jan 1 1999

Fingerprint

Pelvic Pain
Chronic Pain
Psychology
Adrenocorticotropic Hormone
Corticotropin-Releasing Hormone
Sex Offenses
Hydrocortisone
Depression
Gynecological Examination
Life Change Events
Psychological Stress
General Hospitals
Laparoscopy
History
Interviews
Pain

All Science Journal Classification (ASJC) codes

  • Reproductive Medicine
  • Clinical Psychology
  • Obstetrics and Gynecology
  • Psychiatry and Mental health

Cite this

@article{c389fffeb61047ac994c8052e9c56b17,
title = "Psychological and endocrine correlates of chronic pelvic pain associated with adhesions",
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 μg 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.",
author = "Heim, {Christine Marcelle} and U. Ehlert and Hanker, {J. P.} and Hellhammer, {D. H.}",
year = "1999",
month = "1",
day = "1",
doi = "10.3109/01674829909075572",
language = "English (US)",
volume = "20",
pages = "11--20",
journal = "Journal of Psychosomatic Obstetrics and Gynaecology",
issn = "0167-482X",
publisher = "Informa Healthcare",
number = "1",

}

Psychological and endocrine correlates of chronic pelvic pain associated with adhesions. / Heim, Christine Marcelle; Ehlert, U.; Hanker, J. P.; Hellhammer, D. H.

In: Journal of Psychosomatic Obstetrics and Gynaecology, Vol. 20, No. 1, 01.01.1999, p. 11-20.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Psychological and endocrine correlates of chronic pelvic pain associated with adhesions

AU - Heim, Christine Marcelle

AU - Ehlert, U.

AU - Hanker, J. P.

AU - Hellhammer, D. H.

PY - 1999/1/1

Y1 - 1999/1/1

N2 - 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 μg 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.

AB - 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 μg 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.

UR - http://www.scopus.com/inward/record.url?scp=0033007796&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0033007796&partnerID=8YFLogxK

U2 - 10.3109/01674829909075572

DO - 10.3109/01674829909075572

M3 - Article

VL - 20

SP - 11

EP - 20

JO - Journal of Psychosomatic Obstetrics and Gynaecology

JF - Journal of Psychosomatic Obstetrics and Gynaecology

SN - 0167-482X

IS - 1

ER -