Chronic pain can lead to sexual problems in men and women

Of a total of 704 people who complained about chronic pain, 404 said the pain affected their sex lives.

Back pain (illustrative) (photo credit: INGIMAGE)
Back pain (illustrative)
(photo credit: INGIMAGE)
The majority of people who suffer from chronic pain and have partners report that the pain affects their sexual functioning, according to a study at Rambam Medical Center in Haifa. At a seminar on pain and sexuality, researchers reported that migraines and lower back and skeletal pains significantly affect life in the bedroom. Fully 61% of men with chronic pain admitted this, while 39% of the women said ongoing pain affected their sex lives. The average age of subjects was 44.
Hundreds of doctors, nurses and other professionals attended the seminar.
Researchers said that while patients ask for help for their chronic pain, they are usually too embarrassed to mention the resultant harm to their sexual function. Until now, clinical manifestations known to impact sexual functioning have included heart and cardiovascular disease, diabetes, hypertension and depression.
Of a total of 704 people who complained about chronic pain, 404 said the pain affected their sex lives.
Of those who had serious pain problems and took drugs to relieve them, many reported the medications themselves affected their sexual functioning.
Associate clinical Prof. Ilan Greenwald, head of the neuro-urology department who led the study, said that the team members were amazed that the average age of affected persons was only 44, an age when optimal sexual function is important to the partners and when most people don’t complain about chronic pain.
The fact that sufferers were willing to participate in the anonymous survey, he continued, “shows the distress that they feel. Professionals must relate to the issue when they treat patients with chronic pain.”
Joshua Strahl, a hi-tech professional from the US who decided to become a plumber in Beit Shemesh where he lives, never used to follow a healthful lifestyle. But in 2010, he suffered an infection that caused insufficiency of his mitral heart valve diagnosed by Dr. Shuli Zilberman, intensive care head at Jerusalem’s Shaare Zedek Medical Center.
Strahl had such difficulty breathing that he had to undergo open-heart surgery to have the valve repaired.
After the surgery, he joined a rehabilitation program at the hospital. Since then, his sports activities have risen to new heights. He became a marathon runner and then advanced to mountain climbing.
Now 54, he went to Kenya to face a new challenge – to climb to the top of Mount Kilimanjaro as a member of a 17-person group. The mountain, at 5,895 meters above sea level, is the tallest place on the continent. The climbers remained on the mountain for nine days.
“At first, it was hard for me to get used to the altitude, as the air was thin. I carefully planned the trail and gradually got used to it. Beyond the physical challenges, I also had to cope mentally. Of the 17 participants, four were unable to reach the top. The air is very thin and you are supposed to stay for only 15 minutes, but we were so excited that we doubled the time,” he recalled.
His climb also raised $20,000 for Jerusalem’s Shalva Center, which treats disabled children.
“For me, the effort was to give thanks that I am alive,” he said upon his return.
Early predictors of anxiety and depression may be evident in the brain even at birth, according to a study at Washington University School of Medicine in St. Louis. The research was published recently in the Journal of the American Academy of Child & Adolescent Psychiatry.
While analyzing brain scans of newborns, the researchers found that the strength and pattern of connections between certain brain regions predicted the likelihood of the babies developing excessive sadness, shyness, nervousness or separation anxiety by the age of two. Such symptoms have been linked to clinical depression and anxiety disorders in older children and adults.
“The fact that we could see these connectivity patterns in the brain at birth helps answer a critical question about whether they could be responsible for early symptoms linked to depression and anxiety or whether these symptoms lead to changes in the brain,” said child psychiatry Prof. Cynthia Rogers. “We have found that already at birth, brain connections may be responsible for the development of problems later in life.”
Initially, Rogers and her team set out to identify differences in functional brain connectivity – the coordination of activity across different parts of the brain – between babies born prematurely and others born at full term. They conducted functional MRI scans in 65 full-term newborns and 57 infants born at least 10 weeks prematurely. The latter were scanned on or near their due dates.
The researchers looked for differences in the connectivity patterns across various regions of the brain, hoping to find evidence to explain why premature babies face a greater risk of developing psychiatric problems – including depression and anxiety – later in life. In particular, the team focused on how a structure involved in the processing of emotions, called the amygdala, connects with other brain regions.
They found that healthy, full-term babies had patterns of connectivity between the amygdala and other regions of the brain that were similar to the patterns previous studies had indicated in adults. Although there were similar patterns of connectivity in premature infants, the strength of their connections between the amygdala and other brain regions was decreased.
Most interestingly, they noted that various connection patterns between the amygdala and other structures – like the insula, which is involved in consciousness and emotion, and the medial prefrontal cortex, which plays roles in planning and decision making – appear to increase the risk of early symptoms related to depression and anxiety.
When the babies turned two years old, a subset received follow-up assessments to look for early symptoms of anxiety and depression. The researchers evaluated 27 of the children who were born prematurely and 17 born at term.
“Children born prematurely were no more likely than full-term children to exhibit early signs of anxiety and depression,” Rogers said. “Part of that may have been due to the fact that a number of the full-term children already were at risk for symptoms due to sociodemographic factors, such as living in poverty or having a mother with clinical depression or an anxiety disorder. Further, the severity of these early anxiety symptoms was correlated with connectivity patterns seen in the infants in both groups.”
The researchers also want to evaluate all children from the study again when they are nine to 10 years old to learn whether brain connections continue to influence the risk for depression and anxiety disorders.
“We have a grant under review to bring the pre-term children back when they are older, along with the full-term children; we want to study how their brains have developed over time,” Rogers said.
“We want to determine whether they still have many of the same differences in connectivity, whether there have been any changes in the structural and functional connections in their brains and how all of that relates to whether they have symptoms of psychiatric disorders.”