Despite its connection with many serious physical and psychological problems, sexual health is generally ignored by the medical establishment. The physical effects of sexual frustration are to blame for a large number of cases of middle and upper-class women who complain to doctors of vague general pain in the pelvis and back. Some of these women seek psychological or psychiatric help because of severe depression and anxiety, or even serious psychotic disorders. Both the medical and psychological assistance which women may seek is often ineffectual, since the therapy tends to alleviate the symptoms without determining the real causes. Women from the lower income level may suffer the same symptoms and are less likely to get successful treatment for sexual health problems since they usually visit a doctor in extreme situations and never seek help for problems with no obvious physical symptoms. The problem is even more severe for women in developing countries, because the sociological conditioning of women's attitudes towards sex are directly linked to economic status.