Fibromyalgia (FM) is a difficult, life-impairing condition, but it may cause additional problems in women. According to a study titled “Evaluating the relation of premenstrual syndrome and primary dysmenorrhea in women diagnosed with fibromyalgia,” women with FM have more frequent premenstrual syndrome and dysmenorrhea. More severe FM symptoms as well as depression could increase the risk of having these problems. The research report appeared in the February 16th issue of Revista Brasileira de Reumatologia.

FM is a frequently misdiagnosed and misunderstood musculoskeletal condition. It is characterized by chronic pain, often in localized body regions, and fatigue.

The study sought to measure how often premenstrual syndrome, primary dysmenorrhea and depression occur in women with FM and healthy females and to determine possible factors related with PMS and PD in FM. Premenstrual syndrome refers to emotional tension and fluid retention that occurs in the days before menstruation. Primary dysmenorrhea is lower abdominal cramping pain that happens just before or during menstruation.

Led by Rabia Terzi of the Department of Physical Medicine and Rehabilitation in Turkey, the scientists studied 98 women with FM and compared them to 102 age and sex-matched healthy women. The scientists determined whether the participants had premenstrual syndrome or primary dysmenorrhea. According to the study report, “Premenstrual syndrome was assessed among the patients for the presence of one or more affective or somatic symptoms within the five days preceding menses. The diagnosis of primary dysmenorrhea was defined as having abdominal pain or lower back pain lasting at least two days during a menstrual period.” They also measured depression using a standard questionnaire called the Hamilton depression scale.

The investigators did find that women with FM had more problems. Specifically, primary dysmenorrhea occurred in 41% of the women with FM and 28% of the women without FM. Premenstrual syndrome occurred in 42% of the women with FM and 25% of the women who did not have FM. Both of these differences were statistically significant. The risk for having these problems was even higher if when women had more severe FM or if they also were clinically depressed.

Overall, the study authors concluded that “There is an increased frequency of premenstrual syndrome and dysmenorrhea in FM patients. The patients with high symptom severity scores and high depression scores among the FM patients are at risk of PMS and PD.”

FM can be extremely life-debilitating, but may also exacerbate or co-occur with additional problems. Physicians treating FM should look for the presence of premenstrual syndrome, primary dysmenorrhea and depression to improve patients’ treatment and quality of life.