The potential role of complementary medicine in women with pelvic pain

Abstract

A history of trauma and related symptoms, notably dissociation, are prevalent among women with chronic pelvic pain (CPP). High levels of comorbidity exist between CPP and psychiatric conditions associated with trauma. While CPP requires the expenditure of substantial medical resources, it is often considered treatment-resistant, particularly in cases with high levels of comorbidity. Dissociation, a common symptom of trauma, has been linked to numerous adverse physical and mental health outcomes. However, research on dissociation is hindered by conceptual unclarity surrounding the term. Conceptual issues include concerns over the emphasis on psychological over somatoform dissociation and the subsequent failure of modern diagnostic systems to consider potentially dissociative nature of some somatization disorders.The purpose of this scoping review was to gain insight into how dissociation and somatization are conceptualized in the peer-reviewed literature on women with traumatic histories who were diagnosed with CPP.All qualitative and quantitative peer-reviewed studies providing outcome data for women diagnosed with CPP who have a history of trauma published between 1980 - March, 2018 were included. Nine articles met inclusion criteria.Three studies explicitly conceptualized dissociation, and only two of these assessed patients for psychological and somatoform dissociation. Five studies measured somatization without considering the role of dissociation.This study reveals that conceptual unclarity regarding dissociation and somatization exists in the peer-reviewed literature on traumatized women with CPP. A recommended protocol meant to enhance conceptual clarity is provided for future authors.