The effect of reproductive events & alterations of sex hormone levels on the symptoms of fibromyalgia (FM)

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The fibromyalgia syndrome (FS) is a chronic pain disorder
frequently affecting women of fertile age. However, the
relationship of FS and pregnancy has been given little
attention. In the present retrospective analysis, based on
personal interviews, the influence on FS symptomatology by
pregnancy, abortion, menstruation, use of oral contraceptives,
and breast feeding was investigated. Twenty-six women with an
established diagnosis of FS and a total of 40 pregnancies
during disease were included in the study.

With the exception of one patient, all women described worsening
fibromyalgia symptoms during pregnancy with the last trimester
experienced as the worst period. A new change of fibromyalgia
symptoms within 6 months after delivery was reported for 37 of the
40 pregnancies, to the better in four and to the worse in 33
cases, resulting in a prolonged sick leave for 14 patients. An
increase in depression and anxiety was a prominent problem in
the post partum period. FS had no adverse effect on the
outcome of pregnancy or the health of the neonate. In the
majority of patients with FS, hormonal changes connected with
abortion, use of hormonal contraceptives, and breast feeding
did not modulate symptom severity. A pre-menstrual worsening
of symptoms was recorded by 72% of the patients.

Comparing the 26 patients who had borne children during disease
with 18 patients who had all their children before the onset of FS 
revealed a negative effect of pregnancy and the post partum
period of FS and increased functional impairment and
disability in the 26 patients.

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