Fibromyalgia in Men
While only 10% of patients diagnosed with fibromyalgia are men, some physicians estimate that as much as 20% of the male population suffers from the disorder. Diagnosing fibromyalgia in men is complicated by an unwillingness to visit doctors on the part of men and differences in symptom severity.
According to the best available statistics, fibromyalgia in men is rare. Of the 5 million people in the United States with fibromyalgia, something less than 10% are men. The perception of fibromyalgia as a disorder unique to women is relatively pervasive, with many men indicating that support groups, which often contain women only, can be unfriendly or dismissive of men with fibromyalgia.
Despite the rarity of fibromyalgia in men, the disease can nonetheless affect both genders. Whereas fibromyalgia was once dismissed as an “imaginary” disorder, it is now the case that the disease is often dismissed as nonexistent in men, even by doctors. According to Muhammad B. Yunus, a professor of medicine at the University of Illinois College of Medicine, fibromyalgia is a neurochemical disease of the brain in which individuals show any higher than average amount of the neurotransmitter called substance P and a lower than normal amount of serotonin. Substance P is one of the primary neurotransmitters responsible for signaling pain. While both hormones and genetics seem to play a role in the chemical imbalances that cause fibromyalgia, there is evidence that the disease is not exclusive to women.
As Dr. Yunus points out, “women are more susceptible to pain because estrogen reduces the pain threshold.” In other words, women are more susceptible to chronic pain disorders than are men. Interestingly, this means that fibromyalgia may be even more common in men than is currently suspected and that many cases are missed as a result of a higher threshold for pain that most men have. Additionally, because men are less likely to visit the doctor than women, they’re less likely to receive an accurate diagnosis. In fact, most men only receive diagnosis after months or years of suffering, whereas women wait only a few weeks to seek treatment.
Some physicians estimate that up to 20% of men suffer from fibromyalgia, but that they are under diagnosed due to their unwillingness to visit the doctor. They also point out that the longer an individual puts off visiting the doctor, the more they put themselves at risk for developing complications that can affect work, hobbies, or relationships.
Fibromyalgia Symptoms in Men
Fibromyalgia in men is characterized by the same symptoms as is fibromyalgia in women, but the degree of severity of individual symptoms varies. For instance, men are much less likely than women to express that they “hurt all over.” They are also less likely to have fatigue or to suffer from concomitant chronic fatigue syndrome.
On the other hand, men with fibromyalgia are far more likely to suffer from depression or even be suicidal. According to several studies, men often expressed their symptoms in terms of “feeling broken.” Fibromyalgia symptoms in men are also more likely to include headaches, irritable bowel syndrome, and restless legs syndrome.
Characterizing the extent and severity of fibromyalgia symptoms in men has been complicated by underreporting and misreporting of symptoms as a result of differences in the way men and women perceive the extent, severity, and types of pain that they are experiencing. While many studies have indicated that fibromyalgia in men is often less severe and of shorter duration, at least one study has indicated that fibromyalgia in men may be more severe depending on how symptoms are quantified. It seems that the way in which a question is asked and the response that a physician expects can both have an impact on whether fibromyalgia is diagnosed in a man.
The treatment of fibromyalgia in men is very similar to the treatment of the disease in women. SSRIs and other antidepressants are the frontline of treatment as they directly a fact of the chemical imbalance that occurs in the brain as the result of fibromyalgia. As in women, Cymbalta is one of the most effective antidepressants as it targets both serotonin and your epinephrine.
Lyrica has also shown tremendous benefit in men. Most men who take his medication report a 60 to 70% reduction in symptoms. Lyrica is particularly effective in reducing pain and discomfort from restless legs syndrome as well as general aches and pains throughout the body by modifying the pain signals in the central nervous system.
Men seem to also derive enhanced benefit from muscle relaxants. This is thought to be partially due to the increased muscle mass in men.
Like women, fibromyalgia in men is responsive to changes in sleep patterns and improves as sleep hygiene improves. Men are also encouraged to keep symptoms diaries because, like women, various environmental factors can exacerbate symptoms.
While the cause of fibromyalgia in men is no better understood than it is in women, the disorder is responsive to similar treatments, which suggests a common mechanism. Due to differences in psychology and physical structure, men often experience the symptoms of fibromyalgia differently than do women. It is important that physicians understand these differences in order to make an accurate diagnosis of fibromyalgia in men.