Fibromyalgia Symptoms in Women

The Menstrual Cycle, Menopause, & Pregnancy

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As many as 10 million people around the world have fibromyalgia, according to the National Fibromyalgia Association. An estimated 75 percent to 90 percent 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 and 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 some women, pain levels do worsen at different points in the menstrual cycle, such as the premenstrual phase. Some researchers also note that women with dysmenorrhea are more likely to develop chronic pain syndromes, including fibromyalgia.

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 and Menopause

It's easy to find women who say 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. One small study found that more postmenopausal women had fibromyalgia than premenopausal women. Interestingly, premenopausal women with fibromyalgia reported more menopausal symptoms (fatigue, cognitive symptoms, non-restful sleep) while postmenopausal women with fibromyalgia reported fewer of these symptoms.

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 might be contributing factors.

There's much that still isn't known about how fibromyalgia and menopause relate to each other and how the experience of postmenopausal women may differ.

Fibromyalgia and Pregnancy

Research into fibromyalgia and pregnancy is sparse, with studies having some conflicting conclusions about whether there is a negative impact on the health of the baby. A large population-based study published in 2017 concluded that "fibromyalgia is a high-risk pregnancy condition associated with adverse maternal and newborn outcomes." The study of over 12 million births in the U.S. found an increasing prevalence of fibromyalgia in pregnant women. These women were more likely to have anxiety, depression, or bipolar disorder.

The pregnancy problems noted were a higher risk of gestational diabetes, premature rupture of membranes, placental abruption, cesarean deliveries, and venous thromboembolism during birth. The infants were more likely to be premature and have intrauterine growth restriction.

In an older 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.

A Word From Verywell

Several factors may contribute to the higher risk of fibromyalgia in women. Research is continuing to look at how fibromyalgia may affect a woman's symptoms for gynecological conditions. One thing is clear, that you are not alone if you think that the two are tied together.

Sources:

Carranza-Lira SCA, Hernandez IBV. Prevalence of fibromyalgia in premenopausal and postmenopausal women and its relation to climacteric symptoms. Menopausal Review. 2014;3:169-173. doi:10.5114/pm.2014.43819.

Colangelo K, Haig S, Bonner A, Zelenietz C, Pope J. Self-reported flaring varies during the menstrual cycle in systemic lupus erythematosus compared with rheumatoid arthritis and fibromyalgia. Rheumatology. 2010;50(4):703-708. doi:10.1093/rheumatology/keq360.

Iacovides S, Avidon I, Baker FC. What we know about primary dysmenorrhea today: a critical review. Human Reproduction Update. 2015;21(6):762-778. doi:10.1093/humupd/dmv039.

Magtanong GG, Spence AR, Czuzoj-Shulman N, Abenhaim HA. Maternal and neonatal outcomes among pregnant women with fibromyalgia: a population-based study of 12 million births. The Journal of Maternal-Fetal & Neonatal Medicine. 2017:1-7. doi:10.1080/14767058.2017.1381684.

Pamuk CN, Dönmez S, Çakir N. Increased frequencies of hysterectomy and early menopause in fibromyalgia patients: a comparative study. Clinical Rheumatology. 2009;28(5):561-564. doi:10.1007/s10067-009-1087-1.

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