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The Connection Between Endometriosis and Fibromyalgia

Posted on March 23, 2021
Medically reviewed by
Peter J. Chen, M.D.
Article written by
Max Mugambi

Research has shown that women living with endometriosis are at a higher risk of developing fibromyalgia, a chronic neurological condition that causes widespread pain and fatigue, among other symptoms. Fibromyalgia affects at least 4 million American adults or 2 percent of the general population. Women are more likely to develop fibromyalgia than men, with approximately 3 percent of women living with fibromyalgia. But in women with endometriosis, the prevalence of fibromyalgia doubles to 6 percent.

Common Symptoms of Endometriosis and Fibromyalgia

Pain is a common and often challenging symptom of endometriosis and fibromyalgia. Women with endometriosis tend to experience chronic pelvic pain, in particular. People with fibromyalgia may experience persistent and widespread pain.

A common comorbidity of both diseases is chronic fatigue syndrome — a long-term illness characterized by extreme fatigue for at least six months not caused by any identifying underlying medical condition.

“I’m in so much pain, I can hardly walk. Between endo and fibro, I’m done,” said one MyEndometriosisTeam member.

Causes of Endometriosis and Fibromyalgia

Recent research suggests that endometriosis may develop first and become a risk factor for fibromyalgia and other chronic, widespread pain. A 2019 study suggests that fibromyalgia may be more prevalent among women with severe endometriosis, in particular.

The reasons why people with endometriosis are more likely to have fibromyalgia are complex and not well understood.

However, some experts believe that stress caused by endometriosis can trigger inflammation in the body, which increases a person’s risk of a variety of other chronic conditions and autoimmune diseases, including fibromyalgia, inflammatory bowel disease, chronic fatigue syndrome, lupus, and multiple sclerosis.

Other research suggests that endometriosis may lead to fibromyalgia through a process known as central sensitization. In other words, chronic pelvic pain, as in endometriosis, may make the body’s pain pathways more sensitive and easily triggered. Central sensitization leads to widespread pain symptoms. Some findings that fibromyalgia may be diagnosed before endometriosis do not support this idea, although the study’s authors propose the findings may be due to the underdiagnosis or lack of timely diagnosis for endometriosis.

The Impact of Fibromyalgia on Women With Endometriosis

Members of MyEndometriosisTeam occasionally discuss fibromyalgia and how it affects them. “I was diagnosed with fibro first. It’s been a lot of years and a lot of pain,” shared one member.

Another wrote, “I have both endo and fibro. Fibro is more all-over body pain. Basically, my skin is pretty painful and sensitive to touch everywhere. Other fun symptoms are unrestful sleep, fatigue, strange nerve impulses and sensations, IBS symptoms, fibro fog (which affects your mental state), and many other symptoms since it’s different for everyone.”

“I was diagnosed with both within the same year — it was a really difficult time,” said another member. Women with both endometriosis and fibromyalgia may deal with compounding challenges. One study of 48 women with fibromyalgia revealed the impacts of the disease on daily life. Symptoms such as pain, sleep problems, anxiety, and depression were difficult to manage.

Frustration and Stress During Diagnosis

Like with endometriosis, receiving a diagnosis of fibromyalgia can be a long and stressful process for many women. Some are initially misdiagnosed and, as a result, face delays in proper treatment.

Fatigue

Chronic fatigue, or low energy, is one of the most debilitating symptoms associated with fibro, along with chronic pain. Fatigue may be constant and hinder your ability to perform everyday tasks, such as bathing, dressing, and preparing meals. Fatigue may also lead to a need to take naps and a tendency to doze off during the day, even when engaged in important tasks.

Sleep Disturbances

Fibromyalgia causes widespread pain that can make it difficult to fall asleep (and remain sleeping).

Cognitive Impairment

Fibromyalgia can negatively affect your memory and thought processes. Many women with fibromyalgia report a decline in their mental acuity (sharpness) after the onset of the disease.

Emotional and Social Impacts

Women living with fibromyalgia frequently experience anxiety, depression, frustration, guilt, and shame. Fibromyalgia may also have a significant impact on a woman’s ability to maintain their relationships and start new ones — it can be hard to make plans with other people if you can’t predict how severe your symptoms will be.

Fibromyalgia Treatment

If you are living with endometriosis and fibromyalgia, finding the right treatment and management strategies is important for helping you feel your best. Research suggests that effective treatment of one condition can help improve symptoms of the other in co-occurring pain conditions like fibromyalgia and endometriosis.

Read more about treatments for endometriosis.

Treatment for both conditions may need to take a holistic approach. As one MyEndometriosisTeam member shared, “I work with a pain specialist to manage fibro through both lifestyle and medical means. I turned to physical therapy, gentle exercise and stretching, fibro medication, pacing myself in terms of physical activity, diet changes to manage fibro pain and reduce flares, and cognitive behavioral therapy to manage my depression, anxiety, and how I respond to fibro symptoms.”

Medications

Some medications may help relieve pain and improve sleep in fibromyalgia.

Over-the-Counter Pain Relievers

Over-the-counter pain relievers, such as Advil, Motrin IB (ibuprofen), Tylenol (acetaminophen), and Aleve (naproxen sodium), may help relieve mild to moderate pain caused by fibromyalgia and endometriosis.

Antidepressants

Antidepressants, like Savella (milnacipran) and Cymbalta (duloxetine), may help improve pain and fatigue in fibromyalgia.

Antiseizure Drugs

Antiseizure drugs, such as Neurontin (gabapentin), may reduce the symptoms of fibromyalgia. Lyrica (pregabalin) has been approved by the U. S. Food and Drug Administration (FDA) to treat fibromyalgia as well.

Sleep Aids

Your doctor may prescribe the antidepressant Amitriptyline or the muscle relaxant Fexmid (cyclobenzaprine) to help you sleep.

Physical and Occupational Therapy

Physical therapy can help teach you exercises to improve your flexibility, stamina, and strength. Occupational therapists can help make adjustments in your work setup and the way you perform certain tasks to help reduce the strain on your body.

Self-Care and Stress Management

Self-care, including stress management and maintaining a healthy lifestyle, is a critical part of managing fibromyalgia. Try to find ways to limit your physical and emotional stress. Approaches like yoga, meditation, deep breathing, counseling, and avoiding caffeine may help.

Find Your Support System

Living with both endometriosis and fibromyalgia can be challenging, but you don’t have to do it alone. MyEndometriosisTeam was designed to offer support to women with endometriosis and their loved ones. More than 114,000 members come to MyEndometriosisTeam for support, advice, and information on endometriosis and other related conditions.

Do you have fibromyalgia alongside endometriosis? Share your thoughts in a comment below or by making a post on MyEndometriosisTeam.

References

  1. Women With Endometriosis Have Higher Rates of Some Diseases — National Institute of Child Health and Human Development
  2. Fibromyalgia — Centers for Disease Control and Prevention
  3. Patient Perspectives on the Impact of Fibromyalgia — Patient Education and Counseling
  4. Evidence for an Association Between Endometriosis, Fibromyalgia, and Autoimmune Diseases — American Journal of Reproductive Immunology
  5. Chronic Pelvic Pain in Endometriosis: An Overview — Journal of Clinical Medicine Research
  6. Fibromyalgia — Symptoms — National Health Service (UK)
  7. High Rates of Autoimmune and Endocrine Disorders, Fibromyalgia, Chronic Fatigue Syndrome and Atopic Diseases Among Women With Endometriosis: A Survey Analysis — Human Reproduction
  8. A Diagnosis of Rheumatoid Arthritis, Endometriosis or IBD Is Associated With Later Onset of Fibromyalgia and Chronic Widespread Pain — European Journal of Pain
  9. Prevalence of Fibromyalgia Among Women With Deep Infiltrating Endometriosis — International Journal of Gynaecology and Obstetrics
  10. Co-Occurrence of Pain Syndromes — Journal of Neural Transmission
  11. Neuroendocrine and Stress-Related Aspects of Endometriosis — Neuro Endocrinology Letters
  12. Visceral Pain as a Triggering Factor for Fibromyalgia Symptoms in Comorbid Patients — Pain
  13. Fibromyalgia — Diagnosis and Treatment — Mayo Clinic
  14. Endometriosis: Diagnosis and Treatment — Mayo Clinic
Peter J. Chen, M.D. is a fellow of the American College of Obstetrics and Gynecology. Review provided by VeriMed Healthcare Network. Learn more about him here.
Max Mugambi is a copywriter at MyHealthTeams with more than five years of experience writing about a diverse range of subjects. Learn more about him here.

A MyEndometriosisTeam Member said:

This is honestly one of the hardest diseases to get diagnosed. One usually has to undergo a lot of testing to rule out other possibilities before doctors arrive to a fibromyalgia diagnoses. And then… read more

posted 15 days ago

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