The trauma of being sexually abused is more than psychological for many women – it can also lead to chronic pain.
In the first study of its kind, British researchers examined the links between menstrual-related mood disorder and a history of physical or sexual abuse.
They discovered that women who have been abused and experience strong mood changes during their menstrual cycle also feel pain more acutely than other women.
“It seems that a history of abuse and menstrual-related mood disorder both influence pain sensitivity, and that women who have both of these show the lowest pain thresholds,” said Dr. Diana Fleischman, an evolutionary psychologist at the University of Portsmouth.
“These findings may help explain why some women are more likely to suffer chronic pain or pain syndromes.”
Menstrual-related mood disorder is characterized by emotional and physical symptoms that come and go depending on the time of the month. It is more severe than common pre-menstrual tension, effecting about one in ten women.
Symptoms are similar to major depression, post-traumatic stress disorder and panic disorder for the impact they can have on a woman’s quality of life.
Researchers say the study, published in the journal Health Psychology, adds to the growing body of evidence that sexually abused women may be a clinically distinct sub-group of patients.
Over 125 women were divided into four groups: Those who had been abused and suffered menstrual-related mood disorder; those who had been abused but didn’t suffer mood swings; those who had never been abused and suffered mood swings; and those who had never been abused and didn’t suffer from mood swings.
The women were then subjected to two different pain tests; holding their hand in an ice water bath and tightening a tourniquet on the upper arm. They also had their blood levels monitored for stress-related norepinephrine and cortisol hormones.
Women who experienced mood swings and had a history of abuse could cope with the pain for significantly less time than other women, and described their pain as more intense and unpleasant. They also had the highest levels of stress, indicating they felt pain more acutely.
“We have known for some time that emotional factors, and a history of abuse, are major predictors for the development of chronic pain, and the trajectory of chronic pain,” said Beth Darnall, PhD, a professor in the Division of Pain Medicine at the Stanford University School of Medicine.
“This study shows that such a relationship exists in menstrual mood disorders in the context of acute pain. Women with a history of abuse and menstrual mood disorder are more sensitive to pain. Other research has shown that this sensitivity to pain is a predictor for the development of chronic pain. Overall, the findings suggest we need to do a better job at assessing and treating people who have a history of trauma,” Darnall told National Pain Report.
The study also serves as vindication for many women, says author Cynthia Toussaint, whose own experience with chronic pain, chronicled in her book Battle For Grace: a Memoir of Pain, Redemption and Impossible Love, was often dismissed by doctors as being “all in my head.”
“While we already know that men and women experience pain differently, I’m excited to see research that further establishes reasons why women are prone to chronic pain,” said Toussaint. “Better pain management for women is desperately needed, and this study is a step in the right direction.”
Toussaint says many women who suffer from chronic pain are under-diagnosed, under-treated, and often the victim of gender bias.