PMS and Fibromyalgia

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Approximately 85% to 90% of all cases of Fibromyalgia occur in women. As such, it is important to consider the impact Fibromyalgia has on specific women’s health issues. For example, women who suffer from Fibromyalgia are more likely to report having menstrual problems than women who do not have the condition. In fact, increased intensity of premenstrual syndrome (or PMS) is regarded as a symptom of Fibromyalgia. PMS is characterized by increased moodiness, irritability, fatigue, and cramping in the weeks and days leading up to a woman’s menstrual period. The symptoms disappear once the period begins.

Since Fibromyalgia increases an individual’s sensitivity to pain, the physical pain associated with premenstrual syndrome can also be much greater in women with Fibromyalgia, with greater pain in the lower abdomen, lower back, and upper legs. In addition to the physical symptoms, psychological symptoms also are hallmarks of PMS and tend to be more common in women with Fibromyalgia. Women with Fibromyalgia are more likely to have lower levels of the hormone progesterone, which is involved in the regulation of a woman’s menstrual cycle. This can result in greater mood swings, irritability, and depression.

A 2010 study by Amitra and colleagues assessed the similarities between various symptoms and features of Fibromyalgia and premenstrual dysphoric syndrome (PMDD). PMDD is a severe form of premenstrual syndrome. It is characterized by severe depression, irritability, and fatigue prior to menstruation. The authors compared 30 women with PMDD to 26 control subjects without a diagnosis of PMDD. Each woman completed nine surveys to assess the following information: demographic information, health status, Fibromyalgia impact, sleep and fatigue, disability, quality of life, pain level, psychological health, and severity of premenstrual symptoms. Furthermore, each subject underwent a physical examination to measure the common tender points associated with Fibromyalgia, as well as to verbally describe the location of pain and tenderness. The researchers found that those women in the PMDD group had considerably more significant pain and tenderness, in addition to more significant premenstrual symptoms, than the women in the control group. Of interest, five women in the PMDD group had a diagnosis of Fibromyalgia (versus none in the control group). Women in the control group reported a better quality of life than those in the PMDD group, and this was also related to the degree of tenderness reported (i.e., the greater the degree of tenderness reported, the lower the quality of life). Finally, the study found that psychological problems were much more common in the PMDD group, with just over half of all women in that group affected (16 of 30). For comparison, only three of the 26 control group women had significant psychological problems (Amital et al., 2010). In summary, this research showed that women with PMDD have symptoms that are strikingly similar to those associated with Fibromyalgia. It provides interesting evidence to guide future studies that can further evaluate a potential relationship between PMDD and Fibromyalgia.

A 2006 telephone survey of 442 women with Fibromyalgia and 205 women without the condition compared overall health status, reproductive and sleep-related issues, and lifestyle behaviors between the two groups. With regard to women’s health issues, the study found that women with Fibromyalgia were more likely to report having had reproductive health problems, including increased pain during menstruation and breast cysts. Based on their findings, the researchers concluded that patients with Fibromyalgia need careful assessment for various reproductive conditions and assert that more research is needed to better understand the link between Fibromyalgia and women’s health issues (Shaver et al., 2006).

In summary, women with Fibromyalgia suffer from greater pain during menstruation, as well as increased psychological problems associated with PMS and PMDD; however, more research is greatly needed to study the effects of Fibromyalgia on women’s health.

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References

1.        Amital D, Herskovitz C, Fostick L, Silberman A, Doron Y, Zohar J, Itsekson A, Zolti M, Rubinow A, Amital H. The premenstrual syndrome and Fibromyalgia – similarities and common features. Clin Rev Allergy Immunol. 2010;38(2-3):107-115.

Shaver JL, Wilbur J, Robinson FP, Wang E, Buntin MS. Women’s health issues with Fibromyalgia syndrome. J Womens Health (Larchmt). 2006;15(9):1035-45.

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