The Premenstrual Syndrome and Fibromyalgia—Similarities and Common Features

Abstract

The aim of the study was to assess the clinical similarities and common features of fibromyalgia syndrome (FM) and premenstrual dysphoric syndrome (PMDD). Thirty young patients who met the diagnostic criteria for PMDD were included in the study and compared to 26 women belonging to the medical staff of a general psychiatry department. All enrollees were interviewed and examined by a skilled physician. They completed the following nine survey items: demographic information, clinical health assessment questionnaire, fibromyalgia impact questionnaire, sleep and fatigue questionnaires, Sheehan disability scales, SF-36 assessment for quality of life, visual analog scale for pain, Mini International Neuropsychiatric Interview (MINI) questionnaire (assessment of coexistent psychiatric conditions), and the premenstrual severity scale. Additionally, each individual underwent a physical examination measuring the classical tender points and was asked to describe the distribution and continuum of her pain or tenderness. The PMDD group scored significantly higher in the measures pain and tenderness as well as in severity of premenstrual symptoms compared to the control group. Five patients in the PMDD group and none in the control group had FM. Quality of life measured by the SF-36 was higher in the control group than in the PMDD group and correlated with the degree of tenderness reported. Psychiatric comorbidity was significantly more common in the PMDD group, affecting 16 of the 30 PMDD patients compared to only three of the 26 control patients. In this study, patients with PMDD were found to have higher levels of tenderness, higher psychiatric comorbidity, greater level of physical disabilities, and a lower quality of life. These parameters were highly correlated with a lower pain threshold.

Evaluating the relation of premenstrual syndrome and primary dysmenorrhea in women diagnosed with fibromyalgia

“…In these studies, the pain sensitivity to various stimuli in different phases of the menstrual cycle was evaluated in women with and without dysmenorrhea. The pain threshold against pressure, 13 heat, 14 and electricity 15 were reduced in the abdomen, back, and extremities in the menstrual phase in dysmenorrheic patients, whereas it increased against cold. In one study, increased amplitude by CO2 laser evoked cerebral potential in these patients.…”

“…26 Chae et al 27 found a reduction in the pressure pain threshold at acupuncture points in the women with high symptom severity scores in premenstrual syndrome compared to those with low scores. Amital et al 15 investigated the similarities between premenstrual dysphoric disorder and FM syndrome, and found higher levels of tender points and higher rates of psychiatric comorbidities in the patients with PMS. Five of 30 patients with premenstrual dysphoric disorder were diagnosed with FM.…”

“…Several psychological factors and increased central sensitization are accountable for the etiopathogenesis of PMS and PD, as is the case for fibromyalgia. [11][12][13][14][15][16] There is a limited number of studies investigating a possible relationship between fibromyalgia and PMS and PD in the literature. 15,17 In this study, we aimed to investigate the presence of PMS, PD and depression among women with FM and healthy females and to determine possible factors related with PMS and PD in FM.…”

Is Fibromyalgia Syndrome Common in the Patients with Primary Dysmenorrhea?

“…We attributed the unexpected low prevalence of FMS in healthy controls to their younger ages. In accordance to the higher level of tenderness in PD patients, Amital et al (26) assessed the clinical similarities and common features of FMS and premenstrual dysphoric syndrome and reported that patients with premenstrual syndrome were found to have higher levels of TePs.…”

Olfactory impairment in patients with the fibromyalgia syndrome and systemic sclerosis

“…This condition is not associated with genuine tissue inflammation and the etiology of the disorder remains poorly understood. FM patients report increased sensitivity to diverse stimuli among them also nociceptive input, which via different mechanisms converge to hypersensitize the central nervous system and in many manners are similar to patients with post-traumatic stress disorder, depression and other affective conditions [19][20][21][22][23][24][25][26]. Among other characteristics FM patients tend to report enhanced olfactory acuity [27].…”