Researchers at Kocaeli Derince Education and Research Hospital in Turkey recently provided new insights into the possible link between fibromyalgia, dyspareunia and pain threshold in women. The study was recently published in the journal Pain Research and Management and is entitled “The relationship between fibromyalgia and pressure pain threshold in patients with dyspareunia”.

Fibromyalgia is a medical disorder characterized by a set of symptoms that includes widespread chronic musculoskeletal pain, incapacitating fatigue, stiffness and numbness in certain parts of the body, painful response to pressure, headaches, unrefreshing sleep (poor sleep quality), anxiety or depression and mood alterations. Fibromyalgia can affect people’s ability to conduct simple daily tasks, compromising their quality of life. It is estimated that 5 to 15 million Americans are affected by this disorder, especially women. Fibromyalgia is often associated with other comorbidities.

Dyspareunia corresponds to a condition of genital pain immediately before, during or after sexual intercourse. Patients with the disorder are more sensitive to pain and tactile stimuli in the genital area. Pain can be felt around the vagina and in the pelvic region, and the disorder is estimated to affect 8 to 21% of women sometime in their lives. A possible link between fibromyalgia and dyspareunia has been previously suggested.

In the study, researchers analyzed women with or without dyspareunia regarding their pressure pain threshold, number of tender points and presence of fibromyalgia. In total, the team evaluated 40 women with dyspareunia and 30 healthy women as controls. The sexual intercourse history on the previous four weeks was assessed and dyspareunia rated from 0 (no dyspareunia) to 3 (completely prevent intercourse) based on the Marinoff Dyspareunia Scale. The pressure pain threshold was determined and a fibromyalgia diagnosis investigated. The depression status of all participants was also assessed.

Researchers found no significant difference between dyspareunia patients and healthy controls regarding age, body mass index, alcohol use or smoking habits, educational or occupational status. Women with dyspareunia did exhibit a significantly lower tender point mean pain threshold, and a significantly higher number of tender points in comparison to healthy controls. In terms of fibromyalgia, five women in the dyspareunia group were diagnosed with fibromyalgia, while the disorder was not detected in the control group; this difference was, however, not significant. The depression score was found to be significantly higher among women with dyspareunia, especially among those also diagnosed with fibromyalgia.

The research team concluded that patients with dyspareunia may have increased generalized pain sensitivity, not limited to the genital area, in comparison to healthy women. The team suggests that further studies with larger patient cohorts and including brain imaging analysis should be conducted in order to investigate the possible involvement of central mechanisms in dyspareunia pathogenesis, especially brain areas associated with pain modulation and stress.