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Fibromyalgia Symptoms in Women

The Menstrual Cycle, Menopause & Pregnancy

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Updated April 28, 2014

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

As many as 10 million people around the world have fibromyalgia, according to the National Fibromyalgia Association. An estimated 75-90% of them are women.

That prevalence leads to the obvious question of whether sex hormones (estrogen, progesterone) are to blame. Several studies have failed to reveal any consistent abnormalities in these particular hormones in connection with fibromyalgia, but others have suggested that low estrogen levels may contribute to the development of the condition.

Fibromyalgia Symptoms & the Menstrual Cycle

Many women with this condition report especially painful periods, called dysmenorrhea. Many also say their symptom flares coincide with pre-menstrual syndrome (PMS) or with their periods.

While research is mixed on this topic, some research does seem to support that, for a portion of us, pain levels do worsen at different points in the menstrual cycle. One small study found that women with fibromyalgia had more tender points shortly after their periods than they did in the days just before their periods.

It should be noted that fibromyalgia causes normal pain signals to be amplified. This is called hyperalgesia. Whether or not something else is going on during the menstrual cycle, it's likely that normal discomfort associated with PMS and the period is worse for someone with fibromyalgia.

Fibromyalgia & Menopause

If you look online, it's easy to find women saying that their fibromyalgia symptoms got worse after menopause. While that clearly happens with some people, we don't have studies showing whether they are in the majority. (Some experts say that about 1/3 of fibromyalgia patients get worse long term, 1/3 stay about the same and 1/3 make significant improvements.)

In a 2009 study, however, researchers reported that women with fibromyalgia were especially likely to have had early menopause or hysterectomy. They concluded that these may be contributing factors.

There's much we still don't know about how fibromyalgia and menopause relate to each other and how the experience of post-menopausal women may differ.

Fibromyalgia & Pregnancy

We have very little research on fibromyalgia and pregnancy. The good news here is that fibromyalgia in the mother does not seem to have a negative impact on the health of the baby.

One study suggests that women with fibromyalgia may be more likely than other women to have small babies. The study also found:

  • Higher risk of miscarriage
  • Higher rates of gestational diabetes
  • Higher rates of excess amniotic fluid
  • Lower rates of premature birth

Researchers found no differences in the rate of Cesarean deliveries or in the babies' Apgar scores (measures of health taken just after birth.)

In a small study looking at the effects of pregnancy on women with fibromyalgia, all but one participant said her pain and other fibromyalgia symptoms were worse during pregnancy. After delivery, 33 out of 40 women said their illnesses made a change for the worse. Depression and anxiety were prominent post-partum issues.

Women & Fibromyalgia Risk

Several factors may contribute to the higher risk of fibromyalgia in women. For more information on that topic, see: Why Are Women More Prone to Fibromyalgia?

Sources:

Alonso C, et. al. Journal of psychosomatic research. 2004 Nov;57(5):451-8. Menstrual cycle influences on pain and emotion in women with fibromyalgia.

Colangelo K, et. al. Rheumatology (Oxford). 2011 Apr;50(4):703-8. Self-reported flaring varies during the menstrual cycle in systemic lupus erythematosus compared with rheumatoid arthritis and fibromyalgia.

Hapidou EG, Rollman GB. Pain. 1998 Aug;77(2):151-61. Menstrual cycle modulation of tender points.

Okifuji A, Turk DC. The journal of pain. 2006 Nov;7(11):851-9. Sex hormones and pain in regularly menstruating women with fibromyalgia syndrome.

Ostensen M, et. al. Scandinavian journal of rheumatology. 1997;26(5):355-60. The effect of reproductive events and alterations of sex hormone levels on the symptoms of fibromyalgia.

Pamuk ON, Cakir N. Clinical and experimental rheumatology. 2005 Nov-Dec;23(6):778-82. The variation in chronic widespread pain and other symptoms in fibromyalgia patients. The effects of menses and menopause.

Samborski W, et. al. Annales academiae medicae stetinensis. Normal profile of sex hormones in women with primary fibromyalgia.

Zioni T, et. al. Journal of maternal-fetal and neo-natal medicine. 2011 Feb 1. Pregnancy outcome in patients with fibromyalgia syndrome.

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