Difficult Menstrual Cycles Can Worsen Fibromyalgia Symptoms, Study Suggests

Difficult Menstrual Cycles Can Worsen Fibromyalgia Symptoms, Study Suggests

Fibromyalgia symptoms are evident and worse in women who go on to experience a severe and debilitating menstrual cycle (a period of weeks known as premenstrual syndrome or PMS), detrimentally effecting their quality of life (QoL), a study reports.

The study, “Premenstrual syndrome and fibromyalgia: the frequency of the coexistence and their effects on quality of life,” was published in the journal Gynecological Endocrinology.

PMS and premenstrual dysphoric disorder (PMDD) are characterized by both emotional and physical symptoms, with the most common examples being mood swings and abdominal bloating, respectively.

PMS and fibromyalgia syndrome (FMS) are described as belonging to the central sensitivity syndrome family, a term that includes several conditions linked by a unique principle of pathological deregulated nociception (i.e., the sensation or perception of pain), referred to as “central sensitization.”

Researchers aimed to investigate the association between PMS and FMS, and to identify common symptoms and QoL concerns. To this end, they performed a prospective case-control study that included a cohort with 55 PMS patients and a control group of 52 healthy, age-matched women.

FMS diagnosis was based on the relatively new, 2010 American College of Rheumatology (ACR) fibromyalgia diagnostic criteria (2010 ACR FDC), which itself is based on two parameters: the widespread pain index (WPI) score and the symptom severity (SS) score. PMS was further divided in two subgroups according to the presence/absence of FMS.

The researchers detected a 20% frequency of FMS in the PMS group, while none of the healthy controls showed evidence of  fibromyalgia syndrome. Accordingly, the number of PMS-group participants with signs of FMS-related symptoms were higher than those in the control group, as was their number of tender points (TePs).

Authors assessed QoL through the short form-36 (SF-36), a 36-item questionnaire which measures QoL across eight physical and emotional domains. FMS and PMS severity were assessed through the fibromyalgia impact questionnaire (FIQ) and the premenstrual assessment form, respectively.

“The mean mental component summary (MCS) score of SF-36 was low in the PMS group. The mean PAF [premenstrual assessment form] score in PMS with FMS subgroup was higher than those in [the] without FMS subgroup. The mean physical component summary of SF-36 was low in the PMS patient with FMS,” the authors wrote.

Overall, the results suggest that FMS is common among patients with PMS. The frequency of FMS is particularly noticeable in PMS patients having severe premenstrual complaints. Whenever both FMS and PMS are present, patients display increased functional disability.

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