Assessing the prevalence of autoimmune, endocrine, gynecologic, and psychiatric comorbidities in an ethnically diverse cohort of female fibromyalgia patients: does the time from hysterectomy provide a clue?

Abstract

BackgroundThis retrospective chart review investigated differences in the prevalence of medical comorbidity between women with fibromyalgia (FM) (n=219) and a control group women with chronic pain (CP) without FM (n=116). The specific aims were to compare the prevalence of autoimmune, psychiatric, endocrine, gynecologic pathology, the relationship between timing of gynecologic surgery, and pain onset. We additionally sought to compare the number of comorbidities in an ethnically diverse cohort.MethodsThis was a retrospective chart review of patients seen in FM or CP clinics at an academic medical center in 2009–2010.ResultsLogistic regression modeling found that gynecologic, endocrine, and autoimmune diagnoses were independently associated with a diagnosis of FM. Detailed analyses showed that thyroid disease (P<0.01) and gynecologic surgery (P<0.05) were significantly more common in FM. Women with FM were more likely to have multiple autoimmune, endocrine, gynecologic, or psychiatric pathologies. A relationship was observed between the timing of gynecologic surgery and pain onset in FM, with more surgeries observed in the years just prior to pain onset or in the year after pain onset. A similar pattern was not found in the control group.ConclusionThis study demonstrates that autoimmune, endocrine, and gynecologic pathologies occur more commonly in women with FM than in those with CP, which is consistent with findings in less ethnically diverse samples. Moreover, a relationship was found between timing of pain onset and gynecologic surgery. A larger prospective study of the relationship between gynecologic surgery and pain onset in FM is warranted.

Impact of Fibromyalgia on Female Infertility

“…These data suggest a relationship between fibromyalgia and these pathologies and, by extrapolation, infertility. They are also in agreement with the data of [39] that showed a high prevalence of gynecological, endocrine and autoimmune diseases in women with fibromyalgia. The dysfunction of the hypothalamic-pituitary axis is generally associated to fibromyalgia as well as to gynecological and endocrine pathologies [40], thus suggesting a comorbidity with fibromyalgia.…”

“…One of the main factors is hormonal disorders (female hormones and high male hormone levels). It is well known that gynecological and endocrine pathologies are commonly observed in fibromyalgia patients [39]. The diagnosis of fibromyalgia in patients with ovarian cysts is therefore not surprising.…”

Milnacipran poorly modulates pain in patients suffering from fibromyalgia: a randomized double-blind controlled study

“… 5 – 10 Symptom presentation varies greatly between individuals, with a wide variety of clinical, physical, social, and psychological repercussions and of therapeutic responses. Studies on FM pathophysiology report hyperalgesia to experimental stimuli, 10 , 11 – 14 central nervous system abnormalities and cerebral changes, 15 – 19 autonomic and neuroendocrine system abnormalities, 20 genetic factors, 21 and microbiota specificities. 22 …”

Evaluation of sleep disorder and its effect on sexual dysfunction in patients with Fibromyalgia syndrome

“…The exact etiology of FMS is unknown, and the pathogenesis involves psychology, environmental, genetics, hormonal (serotonin), and impaired sleep quality. Brooks et al ( 12 ) found that gynecologic, endocrine, and autoimmune diagnoses were associated with a diagnosis of FMS. They also found a relationship between the timing of gynecologic surgery and pain onset in FMS.…”