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ACEs and Gynecological Problems - A Conversation Starter

ACEs and Gynecological Problems - a Conversation Starter

In the culture in which I grew up, lingering effects of childhood abuse were seen as lack of will power, lack of faith in God or both. What a relief it was when I learned of the ACEs study and joined the ACEs Connection community five years ago!

As a victim of childhood sexual and institutional abuse and as an advocate for those with histories similar to mine, the ACEs study and subsequent research around ACEs brought many things into focus for me and helped frame my story in a way that has brought much healing in my life.

Over the past few years, besides keeping up with posts on the ACEs Connection website, I have read numerous books on ACEs including Childhood Disrupted, The Deepest Well, The Body Keeps the Score and Blind to Betrayal.  

A look through the index of any of these books will show pages where the physical effects of ACEs are discussed: autoimmune diseases, diabetes, cancer, obesity, stroke, heart disease and gastrointestinal problems. Those indices also include pages where estrogen, testosterone and progesterone are mentioned. But you will not see one reference to the sexual organs that those hormones affect or to gynecological problems women who experienced childhood sexual abuse (CSA) often deal with.

I experienced extreme gynecological problems - excessive bleeding, decidual casts, difficult childbirths, endometriosis - from the time my periods started until my ovaries and uterus were removed at the age of 37. Leaving these physical issues out of the ACEs discussion is disheartening to me, especially when research shows a link. (See the attached pdf.) 

This puzzles me. The other diseases linked to ACEs affect both men and women. Is this off advocates' radars because it's a woman's-only issue? Is it subconsciously linked to the long-held notion that women's menstrual problems are in their heads? Is it not included because it is too sensitive or taboo? Is it because women are embarrassed to talk about it? Is there just not enough data?

In my 14-year old head, when I was gushing blood from where I had been violated as a nine year old, I was re-traumatized. When the doctor had to give me a shot of testosterone to stop the bleeding, I was terrified. Event after event followed for decades, always transporting me back to the trauma - something I would not wish on anyone.

If you have any thoughts on this topic, please comment below or send me a private message. My hope is that, together, we can raise awareness of this issue so women who experience what I did can get all the help, support and understanding they need.

Dianne Darr Couts,

Advocate, Speaker, Writer

diannecouts@yahoo.com

(If you email me, please mention β€œACEs” in the subject line.)

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Dear Dianne:
THANK YOU for this post and for sharing and for attaching the list of articles you have found as well. I have also been looking for and finding next to nothing connecting ACEs and cancer and especially ACEs and gyn cancers. Like you, I am surprised at how little research there is about gyn health issues and the impact of childhood sexual abuse, in particular, or of ACEs more generally. I've continued our private correspondence and look forward to reading your book and also to staying in contact around pushing for further research. I will share this article on Twitter with the @gyncsm community which is "a community for those impacted by gynecologic cancers."There are chats in which oncologists, nurses, patients, and advocates gather and share questions, research, etc. I wrote to the authors of the study on the link between adult PTSD and ovarian cancer and risk, and although the nurse study showed a correlation, there's no follow-up research happening and no research on prevalance based on PTSD from adult trauma and sexual abuse as compared to childhood sexual abuse and/or risk for those who have experienced both. We have a LONG WAY TO GO and I so appreciate your blog post, and your work and writing, and attention to this important issue!
Cissy

Hello Cissy & Dianne,

Over the years I have shared articles, resources, websites, etc, related to cancer an trauma, child abuse, etc....here are a few from 2012 & 2014:

 

1] The Surviving Spirit Newsletter December 2012

Out of suffering have emerged the strongest souls; the most massive characters are seared with scars. - Kahlil Gibran

 

Hi folks,

 

Greetings to all and wishing you a belated Happy New Year – 2012 wow!! Another new year and that corny and clichΓ©d phrase, time flies, does ring true when we stop to think of all that we have been involved in and trying to do in our respective lives, both personally and professionally. And there is never enough time in the day to do all that we sometimes want to do. But then again, maybe we are trying to do too much and we need to take time to stop and β€œsmell the coffee”.

 

When we are trying to raise awareness on the issues and concerns of trauma, abuse and mental health, I know that many of us try to tackle and take on too much. The issues are important…but we need to take care of ourselves in these endeavors. I’m aware of this and yet can be as guilty as the next person in not taking time for myself – this year I plan to work on that dilemma. New Year’s Day had me β€˜visiting’ the hospital because of severe chest pains and this found me being tested by all kinds of neat devices and being β€˜wired up’ to many more. They liked me so much, that my visit was extended for another day for more tests – the good news, I’m okay and it was indeed stress related from my β€œwork-a-holism”, some serious family matters and the concerns brought on by the recent diagnosis of my girlfriend’s breast cancer.

 

"In the middle of difficulty lies opportunity." Albert Einstein

 

Cancer – how that word instills so much fear into us. I know it has caused a lot of concern for my dear partner, Mary…again the good news, it was caught early and the two surgeries seemed to have removed all that was cancerous. She still has to face the chemotherapy and radiation to make sure it is all gone. I have also been mindful of how two good friends of mine, Ed and Patricia, are also dealing with their respective cancer concerns.

 

Mary, Ed and Patricia are indeed Surviving Spirits and they have long exemplified all that is good in people by their respective advocacy efforts to help others. Because I know them so well, I am also aware of their trauma and abuse histories and that is why I am sharing this with you.

 

I have known for a long time how trauma and abuse affects our physical health in so many ways – what my girlfriend and my friends are now struggling with only brings that point home front and center. So it is important to gently remind ourselves to be aware and take care of ourselves if you have known trauma and abuse in your life.

 

 

β€œWhen we long for life without difficulties, remind us that oaks grow strong in contrary winds and diamonds are made under pressure.” Peter Marshall

 

With that in mind, here are some helpful links related to these concerns along with some other great resources.

 

 

1] Early Trauma, Diet and Cancer: Holocaust study probes links -

http://healthland.time.com/200...-study-probes-links/

 

2] Childhood trauma and cancer connection - Google Scholar [lots of resources/info]

 

http://scholar.google.com/scho...is=1&oi=scholart

 

3] Please Google - childhood trauma and cancer connection and you will find all kinds of information

 

4] Trauma and Chronic Disease - http://www.nicabm.com/trauma-a...disease/1/confirmed/

 

5] Study Links Child Abuse, Cancer Risk - CBS News - http://www.cbsnews.com/stories...th/main5113472.shtml

  https://www.cbsnews.com/news/s...d-abuse-cancer-risk/ -

 

 

β€œChild abuse casts a shadow the length of a lifetime.” Herbert Ward

 

 

 

2] The Surviving Spirit Newsletter December 2014

 

7] CAN YOU HEAR ME NOW - Self Help Podcasts w/ host Annie O'Sullivan w/guest, David H. Nguyen, Ph.D., - Studies Link of childhood Trauma and Cancer. 12/04/14 One hour show

 

CANCER inCYTES is a public health e-magazine that discusses the health-care needs of disadvantaged populations. The uniqueness of Cancer InCytes is its focus on the link between cancer and social injustice, producing and discussing the latest research on this subject. Our articles become training material for law enforcement, advocates, clinicians, scientists, social workers, and your next-door neighbor. Connecting childhood trauma, disease risk, and social injustice.

 

David H. Nguyen, Ph.D. Editor-in-Chief

Dave is a cancer biologist who does human rights scholarship from the biomedical perspective. He obtained his doctorate in Endocrinology from the University of California, Berkeley.  His research finds new ways of understanding causes and treatments for cancers by studying the transcriptome of tumors in the physiological context of life stages, such as why childhood is a window of susceptibility for carcinogens. He also deciphers the biological processes that link childhood trauma to the risk for developing cancer during adulthood. His other human rights research is about cost-effective experiments to detect the age, race, and gender of anonymous human tissue sold for research purposes. He has co-authored articles in various peer-reviewed journals including Stem Cells, Cancer Research, Clinical Cancer Research,Cancer Cell, PLOS Computational Biology, Proceedings of the National Academy of Sciences, and Journal of Biological Chemistry. d.hh.nguyen@cancerincytes.org

 

β€œThose who play rarely become brittle in the face of stress or lose the healing capacity for humor.” Stuart Brown

Last edited by Michael Skinner
Well said Dianne. There remains so little focus on the effects of trauma on physical health in general and specific diseases and organ systems in particular, including GYN. I was once a family physician and retrained as a somatic psychotherapist. I blog about the research specifically linking trauma and chronic illness, which I discovered only after leaving medicine 20 years ago. I write about different types of trauma that affect risk and one area that adds more info to your terrific reference list is how childhood trauma affects risk for pregnancy complications of all kinds, including difficult births. I refer to these as adverse babyhood experiences (ABEs), which affect mothers, as well as babies (throughout their lives and risk for chronic illnesses and other effects of trauma themselves), and clearly affect fathers too. I have a blog post introducing ABEs and a recently published journal article: https://chronicillnesstraumast...bes-chronic-illness/ I also have a blog post on how pre and perinatal events affect risk for chronic illnesses such as autoimmune diseases https://chronicillnesstraumast...-autoimmune-disease/ and asthma. https://chronicillnesstraumast...-factors-for-asthma/ GYN related issues are one of so many effects of trauma - and what we also see is that the effects of trauma perpetuate into future generations.... thanks so much for sharing and keep up the great work Veronique

Yes you are so right and on the right track. Bravo for sharing your story and speaking out. Please no longer feel that you are alone!

As a family doc I have been very interested in child abuse, its effects and its prevention. In fact I am on a crusade because adult medicine generally is ignorant of and ignores the effects of child abuse on adult physical health. Gynecology is no different except for some attention to intimate partner violence. Your experience is unfortunately a good example of this problem.

Your bibliography omitted one citation I found - which I think is very important: Early life abuse and risk of endometriosis by Holly R Harris Friedrich Wieser Allison F Vitonis Janet Rich-Edwards RenΓ©e Boynton-Jarrett Elizabeth R Bertone-Johnson Stacey A Missmer, Human Reproduction, Volume 33, Issue 9, September 2018, Pages 1657–1668, https://doi.org/10.1093/humrep/dey248.

This is a crucially important study. This well conducted national study set up for other purposes shows that the physical state of laparoscopically proven endometriosis is significantly more common in sexually abused women. The physical effect of abuse on distant body function is boldly demonstrated.Pelvic pain in the abused is not just a mental state!

Feel free to respond (or email me paradocs21@gmail.com) and I will do what I can to help you personally. I am also very eager to have you and other Acesconnections participants join me to create the power and momentum to change the inept and unhelpful attitudes and practices in adult medicine and gynecology.

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Dear Dianne:
THANK YOU for this post and for sharing and for attaching the list of articles you have found as well. I have also been looking for and finding next to nothing connecting ACEs and cancer and especially ACEs and gyn cancers. Like you, I am surprised at how little research there is about gyn health issues and the impact of childhood sexual abuse, in particular, or of ACEs more generally. I've continued our private correspondence and look forward to reading your book and also to staying in contact around pushing for further research. I will share this article on Twitter with the @gyncsm community which is "a community for those impacted by gynecologic cancers."There are chats in which oncologists, nurses, patients, and advocates gather and share questions, research, etc. I wrote to the authors of the study on the link between adult PTSD and ovarian cancer and risk, and although the nurse study showed a correlation, there's no follow-up research happening and no research on prevalance based on PTSD from adult trauma and sexual abuse as compared to childhood sexual abuse and/or risk for those who have experienced both. We have a LONG WAY TO GO and I so appreciate your blog post, and your work and writing, and attention to this important issue!
Cissy

Thank you Dianne for raising up this significant issue. This is such an important conversation, if you are ok with it, I would like to share this on the ACEs in Medical Schools and ACEs in the Faith Based community. Please let me know your thoughts. With gratitude, Karen

Thank you Dianne for raising up this significant issue. This is such an important conversation, if you are ok with it, I would like to share this on the ACEs in Medical Schools and ACEs in the Faith Based community. Please let me know your thoughts. With gratitude, Karen

I would be happy for you to share this in some of the other ACEs communities.  Thanks!

Thank you Dianne for being willing to speak of this. i am sure many other women will identify with the re-transmutation you have described. I am so sorry about the terrible trauma you went through as a child.
Your book "Things Fell Apart, But the Center Held" will also help many also as they see that the center can hold in their lives also. 

 

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