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    Further research is needed to explore whether these psychosocial factors have to buy viagra online in australia a specific relationship to the development and persistence of chronic gynecologic conditions. In reviewing the literature regarding the relationship between chronic pain and depression, Romano and Turner (1983) concluded that at least two distinct groups of chronic pain patients may exist. However, the high prevalence of sexual trauma, marital and sexual dysfunction, and emotional distress in previously studied samples of these patients warrants specific attention to these areas in any clinical evaluation. One subgroup in which pain and depression are a final common presentation reached by a number of pathways and a second group in which depression develops in reaction to pain, as occurs in some other acute and chronic medical diseases.

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