According to Anxiety & Depression Association of America, Generalized Anxiety Disorder (GAD) “is characterized by persistent and excessive worry about a number of different things” and is diagnose “when a person finds it difficult to control worry on more days than not for at least six months” and exhibits at least three associated symptoms, like having an increased heart rate or having trouble sleeping. People who have GAD struggle to control their worry which may hinder other areas of their social, educational, or occupational lives. Based on data from the National Institute of Health of the United States, an estimated 5.7% U.S. adults experience GAD at some point in their life. In adults, women experience GAD at almost twice the rate that men do, at 3.4% and 1.9%, respectively.
In “Dysmenorrhea subtypes exhibit differential quantitative sensory assessment profiles” Hellman et al. examined menstrual pain in reproductive aged women. Although they were not directly studying anxiety, their data showed that “anxiety and somatic symptoms were significantly greater in all symptomatic groups”. This means that the groups of women they studied who had another pelvic pain condition also showed a greater comorbidity rate of anxiety compared to healthy controls.
Practical Pain Management, an all-in-one journalistic website about pain and pain management, published an article in 2021 titled “The Complex Intersection of Pelvic Pain and Mental Health in Women” written by Dr. Kathryn A. Witzeman. There is limited research in this field (also acknowledged by Hellman et al. in their study) but Dr. Witzeman states that based on the existing research that there is a strong association between pelvic pain disorders and mood disorders, including anxiety. She hypothesizes that “this increased comorbidity between persistent pelvic pain and mood disorders, as well as with other pain disorders of disparate body regions, may be influenced by disruptions in the hypothalamic-pituitary-adrenal (HPA) axis and autonomic nervous system, which contribute to the regulation of stress and influence the perception of pain”. Serotonin is a neurotransmitter that has many roles, including mood regulation and the perception of pain. The HPA and serotonin directly impact each other, although how they do so has not been well-defined. What if there was a treatment that could help both conditions?
For women suffering from pelvic pain and anxiety, looking at a type of antidepressant could be an option for managing symptoms of both issues. Selective Serotonin Reuptake Inhibitors (SSRIs) are a type of antidepressant that increase the serotonin levels within the brain. They are a much more safer option compared to addictive opioids and typically cause fewer side effects compared to other classes of antidepressants. There is very little current research that exists on SSRIs and pain management. This could be a new avenue for researchers to look into to help women suffering from pelvic pain and GAD.
Chronic Pain. Chronic Pain | Anxiety and Depression Association of America, ADAA. (n.d.). https://adaa.org/understanding-anxiety/related-illnesses/other-related-conditions/chronic-pain.
Kathryn A. Witzeman, M. D. (n.d.). Pelvic Pain and Mental Health Disorders in Women: Which Comes First? Practical Pain Management. https://www.practicalpainmanagement.com/complex-intersection-pelvic-pain-mental-health-women.
Hellman, K. M., Roth, G. E., Dillane, K. E., Garrison, E. F., Oladosu, F. A., Clauw, D. J., & Tu, F. F. (2020). Dysmenorrhea subtypes exhibit differential quantitative sensory assessment profiles. Pain, 161(6), 1227–1236. https://doi.org/10.1097/j.pain.0000000000001826
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