Variability in cyclicity affects pain and other symptoms in female fibromyalgia syndrome patients

Objective: This study was designed to investigate if the hormonal changes i n the menstrual cycle influence pain and other symptoms in fibromyalgia syn drome [FMS] patients with and without premenstrual dysphoric disorder [PDD] compared to healthy control subjects [HCS], and to assess the degree of co ncomitant affective disorder in the two subgroups of patients. Methods: Sixteen FMS patients and 15 HCS recorded 15 different symptoms dai ly during one ovulatory cycle. The mean values of each symptom per day of e ach patient group and HCS were calculated. Comparisons were made between fo ur different phases of the menstrual cycle in the patient groups and HCS. E valuation of possible concomitant affective disorder was made as well. Results: There was a significant difference in pain, physical and psycholog ical symptoms between the ovulatory and perimenstrual phases in all FMS pat ients with emphasis in the PDD patients. Such a difference of the symptoms was not seen in the corresponding HCS. Compared to the HCS, all FMS patient s: had more severe psychological problems and were less happy during the lu teal phase and perimenstrually. Forty-four percent of all the FMS patients had PDD and the same proportion also had some kind of affective disorder, a lthough most of them of a lesser degree. Conclusion: The results indicate that the changes of the gonadal steroids d uring the menstrual cycle influence the pattern and severity of the symptom s in FMS patients significantly more than in UCS. The affective disturbance s were distributed fairly equally in the PDD and non-PDD patients and were of minor to moderate degree.