Fibromyalgia In Men

Dr. Geo Espinosa | Jan 10, 2013 

The fact that fibromyalgia is a chronic condition typically associated with women is one reason why the disease is often overlooked for men’s health. However, men can develop fibromyalgia as well, and they even appear to experience the disease differently than women.

What Is Fibromyalgia?
Fibromyalgia is an illness characterized by chronic pain, persistent fatigue, sleep disturbances, memory problems and mood shifts, as well as other disturbing and even debilitating symptoms. The American College of Rheumatology estimates that 2 percent to 4 percent of the population has fibromyalgia; but the exact figures are not known because of both missed diagnoses and misdiagnoses, especially among men.^[1] The Centers for Disease Control and Prevention states that the female-to-male ratio for fibromyalgia is 7:1. ^[2]

The disease is usually diagnosed using criteria established by the American College of Rheumatology that were revised in 2010. One of the former criteria involved 18 trigger points — locations on the body that are painful when pressed. This criterion has been replaced by the Widespread Pain Index, a more comprehensive view of the various factors associated with pain.

Studies Of Fibromyalgia In Men
A study published in the journal Arthritis Care & Research explored why men who tell their doctors about fibromyalgia symptoms are less likely to be diagnosed with the disease. According to the study’s lead author, Ann Vincent, M.D., medical director of Mayo Clinic’s Fibromyalgia and Chronic Fatigue Clinic, “Health care providers may not think of this diagnosis when face to face with a male patient with musculoskeletal pain and fatigue.”

The Mayo Clinic epidemiology study involved a survey of adults living in Olmsted County, Minn., and asked them if they experienced the hallmark symptoms of fibromyalgia. Of the 830 people who answered the survey, 5.3 percent (44 individuals) met the criteria, but only 12 had been diagnosed with fibromyalgia.

When it came to gender differences, the researchers discovered that the discrepancy between the people who said they had fibromyalgia symptoms and those who were actually diagnosed was greatest among men — 20 times greater. In comparison, three times more women reported symptoms than were diagnosed. ^[3]

It appears that men experience fibromyalgia differently than women do, at least according to some research. The latest evidence appears in Pain Medicine (December 2012); 24 men and 24 women with diagnosed fibromyalgia were studied. Although women reported having greater pain intensity, more tender locations and more depression than men, men reported having pain for a longer time and more disability than women. In addition, women tended to have greater pain in the cervical spine, second rib, buttocks and index finger than men, while males reported greater pain over the neck. ^[4]

Fibromyalgia And Sexual Function
Since fibromyalgia involves significant pain and fatigue, it’s easy to understand how it can be associated with erectile dysfunction. Researchers decided to study this problem in a recent study that included 37 sexually active men who had fibromyalgia and 30 healthy controls. Using a variety of scales, the investigators determined that men with fibromyalgia had significantly lower scores on the International Index of Erectile Function when compared with controls and that the lower scores correlated with pain and other physical symptoms of sexual health. The authors concluded that fibromyalgia “leads to an impairment in the sexual function in male patients, which is especially strongly associated with age, widespread pain and the quality of life.”^[5]

Take-Home Message
If you experience symptoms of fibromyalgia and have not been diagnosed with the disease and/or have not found relief from your symptoms, you should seek help from medical professionals who are familiar with the disease, such as rheumatologists or chronic pain specialists. Although there is no known cure for fibromyalgia, there are conventional and alternative/complementary treatment options available to manage symptoms and improve quality of life.

Sources:
[1]–American College of Rheumatology: http://www.rheumatology.org/practice/clinical/classification/fibromyalgia/2010_Preliminary_Diagnostic_Criteria.pdf
[2]–Centers for Disease Control and Prevention: http://www.cdc.gov/arthritis/basics/fibromyalgia.htm
[3]–Prevalence of fibromyalgia: a population-based study in Olmsted County, Minn., using the Rochester Epidemiology project. http://onlinelibrary.wiley.com/doi/10.1002/acr.21896/abstract
[4]–Gender differences in pain severity, disability, depression and widespread pressure pain sensitivity in patients with fibromyalgia syndrome without comorbid conditions. http://www.ncbi.nlm.nih.gov/pubmed/23171037
[5]–Sexuality of men with fibromyalgia: What are the factors that cause sexual dysfunction? http://www.ncbi.nlm.nih.gov/pubmed/23124696