Dr Anderson's research is important (HPA axis)

[webslave]

The abstract from the AUA 2007 Annual Meeting by Dr Rod Anderson of Stanford is an important piece of work, in my opinion. In it, he finds that "CPPS men scored exceedingly high on all psychosocial variables and showed evidence of dysfunctional HPA axis function reflected in augmented awakening cortisol responses." He questions whether these observations "represent preexisting characteristics of individuals before the onset of chronic prostatitis / chronic pelvic pain syndrome and activated by chronic pain or a consequence of stress associated with this condition".

Given what we have seen in this forum over many years, I can claim with some confidence that it is a preexisting condition. In other words, men with chronic prostatitis / chronic pelvic pain syndrome have a greater level of arousal and tension than normal people.

Bear in mind that this study, and all the others presented at the meeting, have not passed peer review or had publication in journals yet, so be a little skeptical.

[brettboz]

I agree, I for example have previously suffered from panic attacks going back to when I was 12 years old. I also have a stressful job and expecially during the last few years and has not helped.

Just today I went to my PT session and she told me my muscles are always tense in that area, she tells me to relax but I dont seem to be able to, I dont even realise they are tense, to me they feel relaxed.

[carld]

I found Dr. Andersons review to be the most compelling to me. My strong belief that stress is the pre-existing factor which starts the cascade of events over a period of time. This will then in my opinion effect the nervous system and things like HPA axis and cortisol responses. Stress is a killer and anxiety and panic attacks, something I have had for years is a factor in CP/CPPS. Sure there needs to be more research on stress and tension disorders and the many illnesses the are linked with the heightened fight or flight senses that turn on more then they should with people like my self.

Bravo Dr. Anderson and to all the urologists who are walking the blank for us in this disorder. I think there is still money for them to be made to find a link and treatment that will help us and allow them to make a living.

Regards, Carl...

[Edinburgh94]

Whilst I welcome the research by Dr Anderson I would argue that in some patients cases (not all) it is the condition that creates the anxiety. chronic prostatitis / chronic pelvic pain syndrome happened to me at very happy time of my life and I was n't an anxious person before I had it. I do agree though that stress greatly exacerbates the condition and believe following the SP is the way to conquer it.

There are lots of different ways to get back pain and I think there are similarly many ways to get pelvic pain.

[webslave]

Edinburgh, I accept what you are saying, but at the same time we've seen a lot of posters here who protest how laid back and relaxed they are constitutionally, only for it to be revealed, over time, that they are actually quite keyed up people. That's just an observation, and may not apply to you. It's quite difficult to classify oneself objectively.

[Edinburgh94]

Yeah thats a good point, it is hard to be objective about yourself. Anxiety in many cases probably does trigger the CPPS.

I also believe though that as the science improves on chronic prostatitis / chronic pelvic pain syndrome other ways of creating pelvic floor muscle tension may be revealed. A muscular skeletal doctor explained to me once that he believed tp's could be formed in many different ways. I think there is definitly room for more research on how the tps in the pelvic floor form.

Like I said though I agree with what is said on this website in that you have to control your stress levels to get rid of tension in the pelvic floor. That has been proven beyond doubt.

[Clay]

Most people would have called me laid back, but then, they didn't see the panic attacks.

I recently did a mail order saliva test for cortisol from http://www.canaryclub.org and failed. As of last week, I'm on a full dose of Cortef for adrenal support and thyroid. I don't know if my HPA axis was failing before this all hit me, but it's sure in bad shape now. I have an appointment with an endo next week because my testosterone levels have gone from too high to too low in 4 months, and it could be my pituitary not asking my testicles to produce.

The HPA connection for me has been dramatic, to say the least.

[webslave]

... my testosterone levels have gone from too high to too low in 4 months, and it could be my pituitary not asking my testicles to produce.

That's a fascinating observation, and may point the way to finally explaining the evanescent loss of libido that so often features in CP/CPPS.

From a paper on this issue: "Previous research has established that under certain circumstances a negative relationship exists between the hormones cortisol and testosterone. Bambino and Hsueh (1981) showed a direct inhibitory effect of high doses of glucocorticoids upon testicular Leydig cell function in rats, which resulted in a decrease in the production of testosterone. Cumming et al. (1983) found a similar relationship in humans, using pharmacological doses of cortisol to induce a decrease in testosterone production. These latter researchers speculated cortisol disrupted the testicular testosterone production process (i.e., via disruption of the hormone's biosynthesis pathway)."

[dshoskes]

Whilst I welcome the research by Dr Anderson I would argue that in some patients cases (not all) it is the condition that creates the anxiety. chronic prostatitis / chronic pelvic pain syndrome happened to me at very happy time of my life and I was n't an anxious person before I had it. I do agree though that stress greatly exacerbates the condition and believe following the SP is the way to conquer it.

There are lots of different ways to get back pain and I think there are similarly many ways to get pelvic pain.

To be clear, the preliminary data presented by Dr. Anderson in the abstract only looked at people with established long term CPPS. Therefore it says nothing about cause vs effect.

[Clay]

Good one, Webslave. I thought that testosterone was only affected by ACTH.

[damien6]

Interesting page, thanks fellow stress dudes. Jesus, I know I was wound up 10 ways from Sunday and today fear stress like a loaded gun.

Damien

[latte]

Very interesting thread. This is wonderful compared to where we were five years ago. We are so much more aware of the factors contributing to CPPS. I applaud you all. I wanted to add that a few years ago I played golf with a doctor who said he sees a lot of people with pelvic pain. He has noticed that when they change their life to a less stressful situation the pain often resolves. This didn't surprise me but what he said next really did. He related that the stress they carry in their pelvis is subconscious, that is, they don't know that they are feeling a lot of stress in the pelvis. That's why paradoxical relaxation works. It calms and conscious and subconscious mind.

[Rufus]

viewtopic.php?t=4205&highlight=cortisol

[brettboz]

I have no doubt its sub-concious. In my PT sessions my therapist says I am tense all the time, she tells me to relax I think I am relaxing but she says I stay the same. The other day it got to the point where she said she could do nothing while it stayed that way and got me into some breathing exercises which eventually relaxed the muscles allowing her to work.

[Rufus]

This is old news...

J Curtis Nickel has proposed the idea of a dysfunctional HPA axis regarding chronic prostatitis / chronic pelvic pain syndrome long ago...

Guess he beat Dr. Anderson to the punch...