Is fibromyalgia worse in women?

Fibromyalgia is more common in women than men, who may experience symptoms differently. For example, women tend to report higher levels of pain, and they often have additional symptoms, such as heavy or painful menstruation.

Fibromyalgia symptoms vary from person to person. Some describe the pain as sharp and shooting, while others report a dull ache.

The American College of Rheumatology estimates that 2 to 4 percent of people have fibromyalgia and state that it is more common in women.

Until recently, many doctors dismissed people with fibromyalgia. Because the disease was so poorly understood, these doctors mistakenly believed that symptoms were faked. Some analysts speculate that this may be because doctors historically tended to disregard women’s pain.

In this article, we explore the different ways that men and women may experience fibromyalgia. We also describe common causes and treatments.

Fibromyalgia in men vs. women

The hallmark of fibromyalgia is chronic, widespread pain that cannot be explained by other issues, such as a muscle injury, a herniated disc, arthritis, or an autoimmune disorder.

Everyone with fibromyalgia may experience one or more of the following symptoms:

• persistent pain in several areas of the body, such as the hips, thighs, neck, and back
• dizziness
• chronic fatigue, even after a good night’s sleep
• cognitive problems, such as concentration, or memory
• dry eyes
• heightened sensitivity to pain
• hair loss
• urinary problems, such as frequency
• vomiting
• diarrhea and gastrointestinal issues

Symptoms can vary in intensity, but many find that stress, exhaustion, and illness can make symptoms worse. The type of pain is less important for diagnosis than the pain’s chronic and widespread nature.

Symptoms in women

Women with fibromyalgia may experience heightened or different symptoms compared with men.

Specific symptoms

Women are more likely to experience:

Additional symptoms common to women may involve:

Menstruation

Fibromyalgia can affect the menstrual cycle. Periods may be heavier, and women may experience painful menstruation, which is called dysmenorrhea.

Pregnancy

Many women with fibromyalgia have no problems during pregnancy, but in some cases, pregnancy can worsen symptoms of the condition.

Also, fibromyalgia can lead to heightened fatigue and mood swings, which are common in pregnancy.

Consult a doctor about fibromyalgia and pregnancy, as some medication for fibromyalgia can impact the fetus.

Tender points

Tender points refer to 18 tender or painful spots in nine locations on the body. These spots are paired and located on either side of the spine, for example. Not everyone with fibromyalgia has tender points, but they can help to distinguish it from other pain conditions.

Women with fibromyalgia are more likely than men to have tender points, which are located:

• at the base of the head, where it meets the neck
• between the base of the neck and the tip of the shoulder
• where the muscles of the back connect to the shoulder blade
• on each forearm near the crease of the elbow
• just above the collarbone
• beneath the collarbone on the side of the breastbone
• just above the bony part of the outer hip
• very low on the back, above the buttocks
• inside the knee

Diagnosis

No test can determine whether someone has fibromyalgia. Instead, diagnosing fibromyalgia is a process of exclusion. Doctors ask about symptoms, then test for other disorders that might cause them. If no other cause can be found, a doctor will diagnose fibromyalgia.

To rule out other conditions, a doctor may perform X-rays and order bloodwork. They may also test for tender spots, ask about past injuries, and take a detailed medical history.

A diagnosis is more likely if patients have the following:

• pain in certain tender areas lasting consistently for more than 3 months
• a certain ranking on the widespread pain index
• pain on both sides of the body, and above and below the waist
• a certain level of symptom sensitivity, as determined by the examiner

While specialists and researchers still use tender points to characterize fibromyalgia, it is not always a reliable diagnostic tool, because the presence of tender points can change from day to day. Also, some doctors may apply more pressure during examinations than others.

With tender points excluded, doctors usually look for the following symptoms when diagnosing fibromyalgia:

• fatigue
• difficulty achieving restorative sleep because of pain
• fatigue upon awakening
• difficulty thinking

Causes in women

Doctors do not have a good understanding of what causes fibromyalgia, and there may be more than one factor.

Some research indicates that women with a history of trauma are more likely to develop fibromyalgia. A study from 2017 found that 49 percent of women diagnosed with fibromyalgia had experienced at least one type of adversity, such as emotional or physical abuse, during childhood.

Women with fibromyalgia were also six times more likely to have a history of post-traumatic stress disorder, commonly known as PTSD, than women with esophageal or gastrointestinal disorders.

However, fibromyalgia is not a psychological condition. It instead shows a link between the mind and the body, indicating that a history of trauma can cause or worsen physical pain.

Other theories include:

• Autoimmune disorders. These occur when the body attacks healthy tissue. Many cause inflammation and pain, and some researchers suggest that fibromyalgia may be an autoimmune disorder.
• Central sensitization. This refers to nerves becoming hyperactive and more sensitive to pain. People with fibromyalgia appear to have increased sensitivity to pain, which may relate to central sensitization.
• Inflammation. Fibromyalgia is usually thought of an non-inflammatory, though a 2017 study found widespread inflammation in people with fibromyalgia. This is a process involving the immune system. Inflammation can become chronic and lead to muscle pain, and it also plays a role in conditions such as arthritis.

An event tends to trigger initial fibromyalgia symptoms. The event can be an injury, a traumatic experience, or the development of another disorder, such as arthritis.

People often experience attacks of fibromyalgia that involve heightened baseline symptoms. Many people find that stress, lifestyle changes, and similar events can trigger a fibromyalgia attack.

Treatment

A wide range of treatments can help people to cope with the pain of fibromyalgia. They include:

• therapy focusing on lifestyle changes
• stress management
• exercise
• physical therapy
• medication
• alternative approaches, such as acupuncture, massage, and chiropractic therapy

When to see a doctor

Many conditions can cause chronic pain, but treatments are available to help.

See a doctor if unexplained pain does not get better after a few weeks.

Anyone experiencing pain accompanied by other severe symptoms, such as heart palpitations or difficulty breathing, should seek medical attention right away.

Takeaway

Fibromyalgia is a treatable condition, and after working with a doctor who specializes in chronic pain or fibromyalgia, the pain can be reduced.

While the condition is chronic, and there is no definitive cure, most people can develop a treatment and management plan that allows them to live normally. Still, it may take time to receive an accurate diagnosis and find the right combination of therapies.

Fibromyalgia does not lead to other disorders, is not fatal, and it does not damage the muscles. However, some find that the severity of symptoms changes over time.