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Adrienne Dellwo

Study: Estrogen Drops May Worsen Fibromyalgia Pain

By April 19, 2010

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A lot of us with fibromyalgia say our symptoms follow our menstrual periods, and now that's confirmed by information presented at the American Academy of Neurology's 62nd Annual Meeting.

Researchers say they found that some women have more symptoms from fibromyalgia before or during their periods. They also looked at women with irritable bowel syndrome (IBS) and interstitial cystitis (IC, a painful bladder condition) and got similar results.

The study didn't involve testing estrogen levels, but the researchers think the drop in estrogen before periods may be to blame, because estrogen can prevent pain.

However, the hormonal fluctuations didn't bother all the women in the study. They seem to impact only 18% of those with fibromyalgia, 25% with IBS, and 9% of those with IC. Researchers aren't sure why this is. Also, women on birth control pills containing estrogen appear to have fewer symptoms overall.

This study doesn't surprise me at all -- it only confirms my own experience. In my first year with full-blown fibromyalgia, I noticed that my flares started 2 weeks before my period. That week I was marginally functional, and the following week I was largely bedridden. Once my period started, I'd gradually get better. Then I'd have 1 good week and it would start again.

When I told my rheumatologist about that, she just nodded and said it was normal. But when I told my OB/GYN, he had a suggestion -- endometrial ablation. It's a very quick procedure where they go in and cauterize the uterine lining so it doesn't fill up with blood. That means no more period, and no more of the hormone fluctuations that go with it. It doesn't impact estrogen production, though, so I don't need to take hormones.

Recovering from the procedure wasn't fun, and it took about twice as long as normal, but it's the best thing I could have done for myself. Since then, my flares haven't been nearly as bad or nearly as long. (Ablation is only an option if you're done having children.)

The researchers in this study say they don't recommend going on birth control pills to counter the symptom flare. Certainly, there are a lot of things to consider when it comes to the pill, but it may be an option to bring up to your doctor and weigh against other treatments.

Do your fibro flares follow your menstrual cycle? Have birth control pills helped you, or have you gotten worse after going off of them? Take the poll, and leave your comments below!

Learn more or join the conversation!


April 19, 2010 at 9:21 am
(1) Nancy A. says:

I developed fibromyalgia at age 33, back in 1986. My symptoms were always worst during my period. I’m 56 now and my fibromyalgia definitely got worse with menopause. I worked as a medical secretary for most of the years since 1986 but now I’m on Social Security Disability.

I know this is just my experience, but this shows that fibromyalgia can be a progressive illness, at least for women. I’m hoping that, for the young fibromyalgia patients reading this, there will be much better treatments in the near future.

April 19, 2010 at 12:33 pm
(2) Jodith says:

Initially after my hysterectomy, I felt great. That was mainly because my hemoglobin was 8 before the hysterectomy and just getting it up to normal had a huge impact. But over time, my FMS and CFS have been getting markedly worse (the hysterectomy was 4 years ago). I’m on HRT, but on the very lowest dose of estrogen. I’ve been reluctant to ask the doctor to increase the dose, but now that I’ve read this, I might brave the lion in his den and ask.

And yes, prior to needing a hysterectomy, I was on birth control for the sole reason is helped regulate my periods and made the FMS and IBS better. I had much fewer pain flares back then than I do now. Now it just seems constant.

April 19, 2010 at 1:08 pm
(3) Patty says:

My Fibro started after my Hysterectomy, so it makes total sense. Im NOT on any hormones now and maybe I need to be?

April 20, 2010 at 8:30 am
(4) Nancy A. says:

I also had early-stage breast cancer 9 years ago at age 47. I had a mastectomy and reconstruction surgery. For this reason, HRT is not an option for me. So, I suffer with my fibromyalgia and now with hot flashes for the last few years since menopause. Oh, the joys of womenhood!

April 23, 2010 at 3:31 pm
(5) Sita says:

I have definitely found a connection between the onset of PMS and then my period with my flares from fibro. It starts getting worse two weeks before but it’s a bit bearable, the week before I’m almost bedridden and I start to feel a bit better half way through my period (that lasts about 5 or 6 days…so by day 3 I’m feeling more “normal). I’ve also noticed that as I get older (I’m 34) my cramps are getting worse and worse. So I get about a week and a half before it starts all over again.

I’ve read that after menopause fibro can be worse and I can say that I’m not looking forward to it.

April 23, 2010 at 9:17 pm
(6) Dale says:

I have suffered from FMS/CFIDS for around 54 yrs. I have to agree that as I get older, I am just getting worse. I do believe hormones have a lot to do with both conditions. I have seen four or five endocrinologists, but none of them have known what to do with me, nor are they willing to learn how this condition affects that major system.

We can only hope that in the very near future there will be more answers. Until then, all we can do is deal with it the best we can, & not an easy feat.

April 23, 2010 at 9:55 pm
(7) Robin says:

I have had fibromyalgia for many years, but have gone into a 2 year flare since I started to go through menopause. My pain is through the roof, as my estrogen decreases my pain increases. I hate this, so much pain that I barely sleep anymore.

Not hot flashes just horrid pain and insomnia

April 24, 2010 at 10:27 am
(8) kim says:

Having suffered with cfs for 15 years I have found it is getting worse as I get older. My menstrual cycle makes the condition worse. However since having the merino coil fitted my symptoms arent as bad around my cycle time probably because I no longer menstruate. Which is a result of the merino coil and the small ammount of hormone it produces. Best thing I ever done. It certainly helps. My gynacologist also suggested HRT for boosting energy levels.

April 25, 2010 at 10:59 pm
(9) Rebecca says:

I’ve been ‘cycling’ with my FMS and menstral cycles for years and my doctors have completely ignored it. But when you get only 1 good week a month, and the rest of the time your either going up, going down, or in bed….it’s hard to plan anything. For that one week, your hope get up, and even knowing the symptoms return, I still to this day actually start to hope that they won’t return — and they always do.
I’m 30 years old, no children, no plan to have them. My pain levels are too high, my energy too low — I could never raise one. I can’t even manage a relationship with a guy, which is sorta a prerequisite. I’d have to stop taking my pain meds for a year, and I’m telling you, that’s not happening. Yet I can’t get my doctors to take the next step. They say I’m too young for a hysterectomy. I say it’s MY body, I SHOULD GET TO CHOOSE. I know they are afraid I’ll change my mind, and sue them or something. *rolls eyes* But again, it’s MY BODY. I’ve been trying to get this done for 10 years now, and I feel as if I’m just biding my time until they finally say yes; and in the mean time, wasting what’s left of my youth while I wait for them to finally let me do something that would give me more functionality.

April 26, 2010 at 12:24 pm
(10) Suzie says:

Sad to say, but I am now finding that my cycle absolutely brings on more symptoms, with pain being the most significant! I have also noticed I am far more degenerated now, than when I first noticed and/or was diagnosed with Fibro/CFS. And, they say it isn’t a degenerative condtion? I don’t agree! I cannot take BControl pills; hx of migraines, and they make me viciously sick to my stomach. I am in the perimenopause state, and I would love to hear what else people are utlitizing.

April 27, 2010 at 6:25 am
(11) nathalie says:

I feel so bad for everyone here as I too suffer from these “terrible two weeks” before my period, when my fibro symptoms just go through the roof. So much so that a few hours before my period I can actually FEEL the oestrogen coming back into my system almost like a painkiller has been injected in my veins! And I don’t take any drugs except the odd paracetamol and ibuprofen when I’m too sore to move.

However, I have noticed that some months my symptoms are much much worse than others and I can’t attribute it to overdoing it or stress.

Could it be diet? I have noticed that the months when I eat a lot of wheat or dairy or MEAT (hormones?) during the 1st half of my cycle, my symptoms are much harder to cope with. And vice versa.

Now let’s put dairy and wheat intolerances aside and think for a second:

Since we know our bodies are highly reactive to anything and our symptoms exacerbated by hormonal issues, could the dairy and meat we ingest (from animals given growth hormones) and the wheat we eat (which has been grown on fields sprayed with manure from these cows) be the culprit in disrupting our own hormonal system and make us worse?

That is just a theory from someone trying to connect the dots…

April 27, 2010 at 9:56 am
(12) Helen says:

I’m 43, was diagnosed in 2002 with FMS. I was doing really well handling it. Treadmill, yard work, housework, three kids. I had to get a total hysterectomy in 2006 and each year I have been getting worse. I am fighting to get disability. Haven’t been able to work for two years. My life is upside down. I am on HRT.

April 29, 2010 at 9:38 pm
(13) Judi says:

I don’t know how long I’ve had fibro, but I know it was long before I was finally diagnosed 12-14 years ago. I’m 66 now. When I was having periods, I would have maybe two good weeks right after my period started. After the two weeks, I was like a clock unwinding. The fatigue got worse and worse. Finally in late 1987, I lost my two good weeks. I just never got any energy back. The doctor I was seeing just thought I was depressed. I didn’t take anything at that time. It wasn’t until 1992 that I was put on HRT. I took that for about 9 years, however, I really couldn’t tell much difference in the way I felt.
I finally did get an antidepressant which helped my energy level for a little while. Eventually, I got the fibro diagnosis and was put on some more meds. I’ve taken various drugs since then. I’m certainly not getting any better. The pains get worse the older I get.

April 30, 2010 at 7:31 pm
(14) Maria says:

I’m so glad this article came out now. I’ve had CFS for the past 2 years and last year diagnosed with FM. I’ve noticed the HUGE increase in FM pain during my period, along with deep depression and nausea. The rest of the time it’s not as severe. I believe, now, that may be because I’ve been on a low dose birth control pill for several years to control my endometriosis symptoms. I’m glad to read all this now because I have my well-woman check up with my Gyn next month. Thank you all for sharing!

May 18, 2010 at 10:05 am
(15) Benia Zouras says:

I have always had a pretty awful time during my period, but since Fibromyalgia, I seem to have gotten worse. I almost dependably get a headache, plenty of gas and digestive issues, and awful cramps that come on and cause me to double over to the floor for a minute or two. I’m on Seasonique, which reduces periods to only 4 a year – that helps. I have no desire to have any children and am intrested in a more permanent solution. If this endometrial ablation is as effective as the pill, and also helps me to cancel all periods and the symptoms that come with it, I would do it in a heartbeat.

Thank you for this article. I’m going to ask my gynecologist about this at my next appointment next month.

From Your Guide: To clarify, endometrial ablation isn’t considered a birth-control method, but a post-ablation pregnancy is very dangerous. If you’re interested in sterilization, you should talk to your doctor about tubal ligation as well. ~Adrienne

May 20, 2010 at 9:52 am
(16) Benia Zouras says:

Apparently there are risks, not mentioned here, that are common and should be considered. This is a scary article, but well worth reading if one is considering the procedure, as I am:


May 24, 2010 at 3:06 pm
(17) Geri Berger says:

I have been suffering from Fibro…before they knew what it was….I have IBS and IC…I am way past the Period stage…I also have had mt throid removed…You did not address these issues….please do….ty

July 7, 2010 at 11:48 pm
(18) Lynne B. says:

Re: Fibromyalgia and Chronic Fatigue Syndrome. Read a book called ” Why am I always so tired” by Dr. Gittleman.
I had EBV back in 2008 and have never been the same. EBV, mono…in my 50′s ???
Fatigue set in then the fibromyalgia showed up. Interesting…
I feel so bad and am so tired that I feel like I am being poisoned. I have a high copper diet, lacto – ovo vegetarian, copper pipes in my house, green blue stains in my sink, drink coffee , crave peanut butter and chocolate & feel like I am in PMS mode all the time. In August I have an appt. with a toxicologist to be tested for copper overload or biounavailable copper . Read the book …you will understand.

August 5, 2011 at 6:11 pm
(19) Jacque says:

I have suffered from Fibro for about 4 years now… initially I thought it started from a car wreck but after starting HRT treatments for the onset of menopause, my Fibro has DRASTICALLY improved. I have since wondered if there is a connection with my having a Mirena around the same time as the onset… I definately believe that mine has been from an imbalance in my hormone levels since that time. I am enjoying the relief in my symptoms, regardless. :)

August 27, 2011 at 11:17 am
(20) Holli Rossi Murphy says:

I have noticed an increase in my fibro symptoms before my period more markedly this year. I am looking into getting further testing (by an integrative physician or local pharmacy) for my hormone and thyroid levels to see if there’s something I can do to decrease the fluctuations. I wonder about bioidentical hormone replacement therapy and other supplements.

My doc says that eating a half cup of dry roasted soy nuts a day can help level out hormonal fluctuations. I haven’t kept at it but want to also do things with my diet to see if I can help my symptoms. No sugar or alcohol. Some say coffee is ok, except for putting milk, sugar and other stuff in it.

December 27, 2011 at 1:13 pm
(21) Leslie says:

I stumbled across this site. I have permanent eye pain due to botched LASIK and yes, having ERT hugely helps the pain. I can tell a big difference tween 1 mg and 2 mg.

April 2, 2012 at 8:03 pm
(22) Kristin says:

I have had FM since I was a teenager. I am now 33, I did have a remission that lasted about 4 years. Since I had my 2nd child and had a mirena IUD placed I’ve gotten awful headaches and my motivation has gotten even worse (I didn’t even know that was possible). I had it taken out a couple months ago and my hormone levels crashed a few weeks later. I had an awful migraine, severe widespread pain, no pain meds worked, even lortab, and my skin started to get dry and flake off. About 4 days into this I read that women who get PMS are usually magnesium deficient. I got up and took 1200mg of magnesium right then and a couple hours later my 4 day migraine was gone – unfortunately the other symptoms remained until I started my period at which time I almost instantly began to feel better. Dry skin went away and all . . . until the next month, ugh. Symptoms are less severe since taking magnesium and having the IUD gone, but I still feel awful.

May 7, 2012 at 3:23 pm
(23) Pam says:

Not meaning to bust your bubble about the ablation but I had an endometrial ablation in 2006. Did great, no more hot flashes, night sweats, cramps, leg pain, headaches…..but in early 2011, I started to have night sweats and hot flashes again. Talking to my GYN, I was told that my body was wanting to go thru the change naturally now. GREAT! Thought all that was behind me. I have even had some spotting from time to time and my hot flashes are hitting me more and more, today, 30 min. apart. Not lasting long but driving me nuts. I wanted to try to get through it without meds but if this keeps up, I will change my mind. I have also noticed with the last couple of months that the flashes have been worse, so is the fibro. Women can’t seem to win for losing.

January 25, 2013 at 4:45 pm
(24) Kim says:

I was on birth control pills for over 20 years, started at 12 due to heavy, long periods. Last year I finally stopped them to try for a baby and unfortunately had a miscarriage and was given a new brand of pill to try to stop the bleeding. I took the name brand pill for 2 months then was given the generic. I felt nauseated most of the time so I stopped taking them after 2 weeks. I realized that quite a bit of my fibro pain was gone in the year I was not taking the pill. Now that I’ve been back off it for a few weeks I’m already feeling better. I wish just one of the 6 specialists I’ve seen in the past 6 years would have suggested trying life without it! I forgot how miserable I was while in the pill. I highly suggest giving it a try to see if your symptoms get better (or worse). I’m staying away from drugs for a while, I don’t seem to tolerate anything very well.

February 6, 2013 at 3:18 pm
(25) Ruby says:

Reading the article and the comments, I am right there with you all on the flairs being worse before and during, and then recouping after… problem is for the last two years the time from the first day to the last and then the first day again do not always allow me that recoup time!

My bleeding time now begins with break through spotting and then I have a normal period, with at least one day of heavy, sometimes two, and then I go to light and then back to spotting …they last with the spotting 9-14 days! So am in constant flux. I have fibroids as well, and am 46… so it seems the triple whammy for me.

I have been doing research and have read many are suffering as I am with the same issues. I have seen a doctor, but they offer no help. Only thing they wish to do is run cancer screenings, and as I could not afford them, did not do them, but now figure if I did have cancer, I would have other symptoms and would not be doing well after two years of this.

Just curious is anyone else having these issues??

March 16, 2013 at 3:42 am
(26) Jane says:

It’s not the pain that bothers me. It’s that every month there’s pain but it’s always a little different from before. Just different enough that I think it’s something else. So then I think I’m dying. Until it goes away. But then it happens again. Every month.

March 16, 2013 at 3:45 am
(27) Linda says:

Hi Ruby,
I have something similar to what you describe :\

April 18, 2013 at 7:23 pm
(28) Angela k says:

I too have fibromyalgia, only recently I have been diagnosed with another pain condition, this time of the womb. This condition is called adenomyosis. I am 49. My periods started to become extremely painful,
Then I started bleeding really badly. I went to my doctor, who sent me to gynaecologist. She did a vaginal scan, and imeadeatly confirmed Adenomyosis. I was put on progesterone pills. I also had a biopsy of the uterus. I also had some small fibroids. For a bout 3 years I have suffered in agony with lower back pain, groin pain, hip pain. And the feeling everyday that I was about to start my periods. We all know that feeling. Nasty yes! Any way my point is I just put all this pain and discomfort down to my chronic fibromyalgia. Only when abnormal uterine bleeding started that alarm bell started ringing. Any pain in the female department must be investigated by a gynaecologist . Do not automatically think it is the fibro.
I have had the Merina coil fitted. I have been told it will control my high estrogen levels that have been playing havoc in my body probably for the last 8 to 10 years, with no where to go, other than my womb, which as a result has started to grow fibroids. Premenopausal women always lack progesterone. And almost in all cases produce to much estrogen, which in turn causes painful joints ligaments, and muscles. Like I said your female hormonal status is very important. If out of whack you will suffer pain like fibro pain, and everything eles that a company’s it. Please get yourself checked out. Just do not assume it is fibromyalgia. Women as young as 30 can be Perimenapausal. Not just us women who are around the 50 year age group. I feel fine so far and can report no fibro pain any where in my body. Fibro ladies look after you own health.

May 27, 2013 at 9:43 am
(29) Kate says:

I appreciate these commenta – 43 yrs old and just diagnosed with fibromyalgia and EBV. Have progesterone coil for last 3 months and pain at ovulation and period is unbearable with two young kids to look after too! Only respite is epsomi bath SALT bath, menopause supplemento containing soya isoflavines which normalise estrogen levels. Accupuncture definitely helps too. About to try amyptriline anti-depressant meds as rheumie and gastro Dr suggest they are effective. Keep you posted.

October 30, 2013 at 4:38 am
(30) Sharon Edwards says:

Hi, I am 43 years old, and since I came of the implanon over a year ago, I started with severe hip pain in both hips, day and night, the pain is so severe it wakes me up 3 – 4 times a night. Over time I noticed that my period was only lasting 3 days when before implanon it was a 7 day period. During implanon I had no bleed at all. The pain in my hips comes and goes around my cycle each month. so for about 2.5 weeks I have severe pain in my hips then I get my period and the pain starts to lessen and goes, the pain then gradually builds again and it is a cycle. My doctors are useless, they have half written prescriptions before you even get in there, I am getting to the point were I just want to give up, I feel down all the time because of the pain

April 14, 2014 at 1:57 pm
(31) Gary says:

There has been some research going on with giving men estrogen to help with IBS and fibromyalgia as many find when testosterone is high it increases pains/symptoms.
Did get talking to someone other week that after going through all the various meds and exams etc they have tried him on one of the combi pills which they said works on pain receptors etc which FMS causes problems with as like many but quack denies have bladder/bowel problems from it. but he did say it has helped a lot and sleeps better did say not too many side effects been taking 4 months odd.
they did give him one with higher progesterone amounts though as said to have estrogen only as not trying to block testosterone but work along side it and make it more effective.
but do think more should be researched and tried with other things like this as many meds are being cross used now as finding it works on other things not thought of/designed for?
It could be it kick starts your own hormones up if you change levels of either types i know progesterone is a main one that helps both sexes.

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