Stress and Chronic Prostatitis/CPPS
Many men correlate the onset of CP/CPPS to severe stress
The effects of stress-induced hyperalgesia (increased sensitivity to pain) have been well documented in both the basic science and clinical literature. From such reports, it is known that stress can exacerbate chronic pain conditions. An acute stressor evokes increased symptoms of pain and urgency in patients with interstitial cystitis but not in controls.
The basic concepts here are that stress:
- increases pelvic muscle tension and nerve activity in the pelvis, causing the nerves to secrete neurotransmitters from nerve endings that then activate mast cells, causing inflammation and pain
- can cause neuroendocrine imbalances, leading to chronic pain and fatigue syndromes
- dysregulates the HPA axis (adrenocorticotropic hormone) and cortisol levels
All of these actions could cause or exacerbate chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and IC.
Diagram Showing How Stress activates Mast Cells
Increased secretion of neurotransmitters
It should be understood that this aspect of stress overlaps with the “Neurogenic” theories, because stress fires up nervous activity which leads to symptoms, to simplify matters. There are several studies showing how stress may cause BPS/IC, a closely related condition. Here are further studies that show that nerves in the lower urinary tract sit alongside mast cells, and can cause them to degranulate, leading to inflammation, under psychological stress:
- Role Of Afferent Neurons In Stress Induced Degenerative Changes Of The Bladder (@ International Prostatitis Research Foundation website)
- CNS Induced Neurogenic Cystitis Is Associated With Bladder Mast Cell Degranulation In The Rat (@ International Prostatitis Research Foundation website)
- Neurotensin Mediates Rat Bladder Mast Cell Degranulation Triggered By Acute Psychological Stress
In a 2001 study cats with chronic pelvic pain syndrome (bladder pain sydrome, feline interstitial cystitis) showed increased sympathetic nervous activity compared to normal cats. That means they were stressed out. These cats also were found to have small adrenal glands, which is something found also in CFS patients. And CFS is frequently found alongside CP/CPPS and IC. It all starts to tie together, but it’s very complex, which is why your local doctor and even urologist may not have a clue about what’s happening to you.
Similar study: J Urol 1998 Mar;159(3):1045-8 Increased tyrosine hydroxylase immunoreactivity in the locus coeruleus of cats with bladder pain syndrome/interstitial cystitis (BPS/IC). Reche Junior A, Buffington CA
Below is a quote from an interesting study showing that stress is linked in a very complex way to inflammation and chronic pain syndromes, as well as chronic fatigue syndrome. It talks about the close “neuro-mast-cell connections in peripheral tissues” like the lower genitourinary tract. On nerves, stress and hormones, the author hints at adrenal fatigue from stress:
The chronic pain and fatigue syndromes
Several chronic pain and fatigue syndromes (such as fibromyalgia and chronic fatigue syndrome) have been associated with chronic sickness syndrome manifestations (such as fatigue and hyperalgesia) and with hypoactivity of the stress system (Table III).