Symptom perception in relation to hormonal status in female fibromyalgia syndrome patients

Objectives: The study was designed to investigate if symptom severity and well-being differed in post- and premenopausal fibromyalgia syndrome [FMS] patients and to compare postmenopausal FMS patients to healthy age matched postmenopausal women. Methods: The patient sample comprised 35 FMS female patients, who were divided into post- and premenopausal subgroups. Daily prospective ratings of pain and other symptoms were performed during 28 days. For the premenopausal women the symptoms from the ovulatory and perimenstrual phases were calculated. Psychopathological rating scales were used to detect well-being, and pressure pain threshold [PPT] was used to define pain sensitivity of both patients and controls. Results: The postmenopausal patients reported less happiness, worse well-being and global functioning compared to both the premenopausal patients and the postmenopausal healthy women. There was significant difference with more pain in the perimenstrual than in the ovulatory phase in the premenopausal patients, as reported earlier, but there was no difference in pain scores, PPT and summarized other physical symptoms between the hormonally different patient subgroups as a whole. All FMS patients scored significantly higher with symptoms related to stress and tension such as anxiety, stiffness and headache than the postmenopausal controls. There was no difference in duration of disease between pre- and postmenopausal patients. Conclusion: Postmenopausal FMS patients seem to be in worse condition regarding psychological symptoms compared to premenopausal FMS patients and also worse both physically and psychologically than postmenopausal healthy women. Whether the difference between the pre- and postmenopausal FMS patients is due to hormonal factors requires further study, however, psychological and social factors may also be of importance. All FMS patients seem to be more sensitive to stress than the postmenopausal controls.