During a recent radio podcast of his show Loveline, Dr. Drew Pinsky made some controversial remarks about pelvic health. In short, he said that chronic pelvic pain, like endometriosis, is what some refer to as a "garbage bag diagnosis" and implied that it may be a sign of sexual abuse.
Here's what happened: The caller told Dr. Drew that his fiancé has been diagnosed with several disorders including endometriosis, interstitial cystitis (a painful bladder syndrome), and lactose intolerance. While it's not clear exactly what the caller's question was, Dr. Drew swooped right in with an answer:
"These are all sort of what we call functional disorders. Everything you mentioned, everything you mentioned, are things that actually aren't discernably pathological. They're just sort of what we call 'garbage bag diagnoses.' When you can't think of anything else you go, 'Eh, well, it's that.' So it then makes me question why is she so somatically preoccupied that she's visiting doctors all the time with pains and urinary symptoms and pelvic symptoms and all this stuff? And that makes me wonder was she sexually abused growing up?"
Um, what? Garbage bag diagnoses? That's not only offensive, it's also incorrect. While it's true that sometimes these disorders can be diagnosed through the process of elimination, that doesn't mean that that's always the case. "Endometriosis can definitely be diagnosed," says Shahin Ghadir, M.D., reproductive endocrinologist at Southern California Reproductive Center. If someone is willing to undergo the correct procedures—typically done with a surgical biopsy of the tissue—then they can definitively diagnose and treat the disorder. "I wouldn't call it a garbage bag diagnosis," says Ghadir.
But unfortunately, the call didn't end there. After a little back and forth, Dr. Drew asks again if the caller's fiancé was sexually abused and, interestingly, the caller says that she was. Dr. Drew seems pretty pleased with his prediction and explains why: "When people have unexplained pain, particularly pelvic pain, it's called somatoform dissociation, and the only way her body, which was suffering during those early experiences, can tell its tale of woe is with pain and she really needs to see a trauma specialist not a urologist. So really work on that. It's a real thing."
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Here's the thing, somatoform dissociation is a real thing, but it is by no means the only explanation for these disorders. Not every woman with several, somewhat similar diagnoses should worry that she has a somatic symptom disorder stemming from sexual abuse. While it's possible that a woman who was sexually abused may suffer from somatic symptoms without a medically explainable diagnosis, Ghadir notes that this obviously isn't always the case. And in fact, this variety of symptoms (a bladder issue, a pelvic issue, and a gastrointestinal issue) wouldn't even typically be lumped together as "unexplained pelvic pain." Essentially, it was a lucky guess on Dr. Drew's part.
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Anyone who has suffered with endometriosis (approximately 176 million women globally) can attest that this is a very real and very serious disorder, so regardless of the point that Dr. Drew was trying to make, his choice of words was poor, to say the least.
We're sure you're not getting the majority of your health information from podcasts, but still, remember to check with your physician before jumping to conclusions about your own symptoms. And if you aren't getting answers from your doctor, don't be afraid to see a specialist who may be able to give you more insight, says Ghadir.
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