NEW YORK (Reuters Health) - Women with chronic pelvic pain should be routinely evaluated for abuse and for posttraumatic stress disorder (PTSD), conclude doctors from North Carolina.

Among 713 consecutive women seen in a pelvic pain clinic, 46.8 percent reported sexual or physical abuse, or both, according to the report in the medical journal Obstetrics & Gynecology.

"One half of the women had two or more lifetime traumas," the researchers report. Trauma included abuse episodes as well as experiences such as life-threatening illness or injury, being in foster care or prison, or having a close friend who was murdered or killed in an accident.

Nearly one third (31.3 percent) of the women were given a diagnosis of PTSD, indicating that many patients in this population have more than one psychiatric disease that may potentially affect the patient's "perception of and ability to cope with chronic pain," write Dr. Samantha Meltzer-Brody and colleagues from University of North Carolina at Chapel Hill.

After the investigators considered the effect of factors such as age, education and race, they found that more trauma was significantly related to worse health status on all variables.

Specifically, trauma correlated with worse daily physical functioning due to poor health, more medical symptoms, more lifetime surgeries, more days spent in bed and more dysfunction due to pain (p value < 0.001 for all).

A positive diagnosis for PTSD was also highly related to all measures of poor health status, "and somewhat explained the trauma-related poor health status."

Based on their findings, Meltzer-Brody and colleagues conclude that "obtaining an abuse and trauma history, as well as an assessment for PTSD, are critical components of the comprehensive evaluation of patients with chronic pelvic pain."