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Relief From Chronic Pelvic Pain

Many women -- and their doctors -- never realize the mysterious pain they feel has a diagnosis.

New Understanding of Chronic Pelvic Pain continued...

Another expert, Deborah A. Metzger, MD, PhD, has a different take. She believes inflammation causes chronic pelvic pain. "Treat the inflammation, and a lot of the pain goes away," she says.

She's found that sugar and allergies are involved in chronic pelvic pain. "I always test for allergies," she says. "For example, vulvar pain for most women is related to food allergies. Another component is allergies to skin fungi, such as candida."

Metzger, medical director of Harmony Women's Health in Los Altos, Calif., takes an integrative approach to CPP. She tells WebMD it's time for health care professionals to expand their view of women's health. "It's more than periods, menopause, and having babies," she says. "The true picture of women's health involves all the problems that are predominantly female, including IBS, chronic fatigue syndrome, fibromyalgia, depression, allergies and asthma, autoimmune disease, and thyroid disorders."

The field of pain management adds another piece to the chronic pelvic pain puzzle. Roy E. Grzesiak, PhD, is a consulting psychologist with the New Jersey Pain Institute at the University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School in New Brunswick, N.J.

"We need to differentiate between people who have persistent pain based on a biological illness or dysfunction and go on living and loving and parenting, and those people whose total being gets enmeshed with pain, treatment, the drugs, getting disability, etc. Many in this latter group have a history of trauma, such as rape, sexual abuse, or physical abuse."

He says the neurobiological effects of trauma are complex and don't always make sense from a biological scientist's point of view. Grzesiak is the author of A Psychological Vulnerability to Chronic Pain.

"The terror and violation of the body do not go into one's memory system as 'I have been raped,' or 'I have been violated,'" Grzesiak says. "It goes into the non-linguistic side of brain as the experience of terror and as the feeling of being violated, not as the memory of the event."

In addition, he says trauma speeds up the nervous system so that any painful sensation is perceived to be severe. "These patients can't graduate pain, like it's a two or three or four. The pain is either off or on, and when it's on it's severe."

Another effect of trauma that's being explored has to do with issues of a patient's trust. "They may have difficulty trusting health care providers," says Grzesiak, who is also clinical associate professor of psychiatry at UMDMJ-New Jersey Medical School in Newark. "Invasive surgeries and a lot of medical procedures violate people. The physician is doing something that's made them anxious all their lives."

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