By Lynne Matallana
Six to ten percent of Americans are thought to suffer from fibromyalgia. Millions of men and women worldwide, of all ages and ethnicities, suffer from this chronic pain condition, yet fibromyalgia is significantly more common in women than in males. This is also true of several other pain conditions, including headache, irritable bowel syndrome, and temperomandibular joint dysfunction.
Males and females perceive pain differently, according to research on both people and animals. Both human and animal females are generally more sensitive to experimental pain, and women are more likely to suffer from pain-related clinical disorders such as fibromyalgia, rheumatoid arthritis, and osteoarthritis.
Furthermore, research has indicated that cultural influences can possibly be involved. For instance, it is commonly believed that emotional reactions are socially acceptable and that women are “oeokay” or even expected to experience pain. On the other hand, ignoring  and failing to report discomfort are requirements of conventional masculine roles in society, which can result in feelings of anxiety and depression.
Research has indicated significant gender disparities in a number of fibromyalgia clinical traits. For instance, women are much more likely than males to suffer from common fatigue, morning weariness, all-over pain, irritable bowel syndrome, and a variety of other symptoms. Additionally, women usually have a lot more delicate spots. However, there are no appreciable differences between the sexes in terms of total pain severity, global pain severity, physical functionality, or psychological aspects like stress, anxiety, or depression. According to renowned fibromyalgia researcher Dr. Mohamed Yunus, the mechanisms underlying gender disparities in fibromyalgia are not entirely understood, but they most likely entail interactions between biology, psychology, and societal variables.
Although the main function of female hormones, such as progesterone and oestrogen, is in reproduction, it has also been demonstrated that these hormones have significant impacts on the central nervous system and, in turn, on pain. However, there is conflicting evidence about the effects of oestrogen, particularly with regard to pain. Oestrogen is generally excitatory to the central nervous system, so much so that some people with seizure disorders experience “oecatamenial seizures,” a condition in which their symptoms aggravate during the period when oestrogen levels are at their peak.
Progesterone, on the other hand, suppresses central nervous system activity. Different hormone levels may therefore have a similar influence on pain as they do on mood: either too much or too little of one can lead to issues. While too little oestrogen may prevent the brain’s natural pain-control mechanism from activating, too much oestrogen may cause pain-related nerves or brain regions to become hyperactive. The fact that the study of gender’s impact on the biology of pain is still in its early stages contributes to our difficulty in comprehending the role of hormones.
Additionally, a lot of women have fluctuating pain levels during their menstrual cycles. Therefore, it would appear likely that female hormones influence how pain is perceived. For instance, the menstrual cycle affects several types of pain. The follicular phase (low oestrogen) has the highest pain threshold, whereas the luteal phase (high oestrogen) has the lowest. For example, migraine, a disorder that is more common in women, gets worse throughout the menstrual cycle and gets better after menopause. Similarly, migraines tend to get better throughout pregnancy.
In contrast to the national average of roughly 18 percent of women aged 40-44 (i.e., at the end of child-bearing years), 26.5 percent of female respondents (average age 47.3 years) in the latest NFA-sponsored epidemiological survey reported never having children. It’s unclear why the number among women with fibromyalgia appears to be higher. There might be an unidentified biological link, or it might be the outcome of decisions made as a result of having incapacitating, chronic pain.
Those who are diagnosed with fibromyalgia face a problem beyond managing their symptoms, similar to other so-called “oeinvisible disorders”: the battle for legitimacy. Because there are no outward symptoms, it is all too easy for people who have never experienced fibromyalgia to disregard it. Similarly, because there is no blood test that can determine whether a person has fibromyalgia, it has been all too easy for medical professionals to disregard the symptoms that people with the condition describe. With the heading, “Drug Approved,” a New York Times piece highlighted this difficulty. Does Illness Exist? (Jan. 14, 2008).
Thankfully, studies are showing that fibromyalgia is all too real, and even the most ardent sceptics can easily see the evidence. For example, MRIs reveal variations in the brains of individuals with fibromyalgia and those without the chronic pain condition.
Over the past ten years, there has been a significant increase in public, media, and medical awareness of fibromyalgia; yet, there is still much to be done.
Those who have been diagnosed with fibromyalgia can do their part by educating their friends, family, colleagues, and supervisors about this chronic pain disorder, the millions of Americans it impacts, the symptoms they strive to manage, and what they require in the way of support from their loved ones.
