Symptoms of Fibromyalgia and Sexual Dysfunction
Fibromyalgia symptoms can overlap with autoimmune diseases and other musculoskeletal conditions making it difficult to diagnose. The defining symptoms of fibromyalgia are often associated with other subjective and objective symptoms which occur in combination. It is estimated that fibromyalgia syndrome affects about 2 percent of the U.S. population.
The Diagnosis of Fibromyalgia
In 1990, the American College of Rheumatology (ACR) listed two primary criteria for the classification of fibromyalgia. 1) A history of widespread pain involving all four quadrants of the body (right side, left side, above waist, below waist) for a period of at least 3 months. The second criteria from the ACR which points to fibromyalgia is, upon physical examination, the presence of pain in at least 11 of 18 tender points when touched or pressed with force amounting to the equivalent of 9 lbs. More recent data indicates that there may be an increased sensitivity to pain throughout the body, pain may be migratory (move around) or may exist as chronic regional pain. Most experts are said to believe fibromyalgia results from abnormal central nervous system function. Response to stress may also contribute to fibromyalgia. Fibromyalgia primarily occurs in women of childbearing age. Children, the elderly, and men can also be affected. Besides the defining symptoms of pain and tenderness, there are many non-defining symptoms associated with fibromyalgia including:
- Fatigue, night sweats, and sleep disturbances.
- Memory difficulties and cognitive difficulties.
- Tension or migraine headaches, rib cage pain, chronic pelvic pain, or heel pain.
- Fluctuations in weight, heat or cold intolerance, subjective feeling of weakness.
- Ear-nose-throat complaints, multiple chemical sensitivities and a wide array of allergic symptoms.
- Hearing, vision, and balance abnormalities.
- Heartburn, palpitations and irritable bowel syndrome.
- Mood disorders such as depression and anxiety occur more commonly in people who have fibromyalgia.
When you’re exhausted and it hurts just to be touched, it’s pretty much a given that it’s going to impact your sex life. Several studies have looked at sexual dysfunction in women with fibromyalgia, and a recent survey of them concluded that there is definitely a link. The authors say we need more studies to figure out why.
Here are other things that could contribute:
- Fibromyalgia-related strains on our relationships
- Higher likelihood of pain related to intercourse
- Poor self-esteem from losing abilities/functionality
- Your partner’s fear of hurting you
- Sexual side effects of medications (especially antidepressants)
- Brain-chemistry abnormalities of fibromyalgia affecting sexual desire
Tips on Talking to Your Doctor about Sex
Talking with your doctor or health care professional about sex can be very hard. They are often rushed and may not give an obvious opening to a conversation about sex. Doctors have widely varying degrees of sexual knowledge. Some medical schools offer sexuality courses, but they are rarely required. Most doctors will have some training around sexual dysfunction, and will know about STDs, but will have very little general knowledge about other aspects of sexual health.
Plan Before You Go
Doctors tend to interrupt patients early on when they are trying to talk about their concerns, so think about what you’d like to ask, and see if you can put it in a question that is one or two sentences. You can fill in the details afterwards.
Do Some Research First
The internet is a great resource for health and medical information. If you have concerns, or are worried you may have a physical condition/illness/disease, do some research on your own first. You can bring what you’ve read in with you, or use your doctor to explain anything that may not be clear. Using online resources that physicians are familiar with can be a good idea.
Be Prepared for Their Discomfort
We tend to project a lot of expectations on our doctors. But like anyone else, your doctor may be uncomfortable talking about sex with you. This doesn’t mean that you can’t do it, and it doesn’t mean that your doctor can’t be helpful to you. Being prepared for a little bit of awkwardness will guard against you backing out at the last minute. In the long run, you will be happy that you endured this uncomfortable conversation because there is hope that a physician can provide through proper treatment.