Did you undergo a gynecological surgery, such as a hysterectomy, a few years before the onset of fibromyalgia?
Some people have noticed this trend and a study published in 2015 establishes the link between these types of surgeries and the appearance of fibromyalgia. It also provides additional evidence of an association between fibromyalgia and overlapping, gynecological, endocrine, or autoimmune conditions.
As part of the study, researchers examined the records of 219 women with fibromyalgia and 116 women with chronic pain other than fibromyalgia. Specifically, they examined the time elapsed between the onset of the disease and gynecological surgery, as well as the number of overlapping diseases in each group.
They also found that each of the three types of diagnosis studied was independently associated with fibromyalgia. Thyroid disease and gynecological surgery were significantly more common in women with fibromyalgia than in those with other types of chronic pain.
The timing of gynecological surgeries in relation to the onset of pain was particularly interesting. They found more surgeries in the years before the onset of fibromyalgia-related pain or the year after the onset of pain. This model was unique to the group of fibromyalgia.
At first glance, it may seem odd that gynecological surgeries performed in the year following the onset of pain are considered to be related to the development of fibromyalgia.
However, such an association may be due to several relevant factors.
For example, consider that many women have gynecological problems long before opting for surgery as the treatment of choice. Hormonal changes or gynecological diseases may be risk factors for fibromyalgia because of an underlying relationship that we do not yet understand.
According to the study, hysterectomies and ovariectomies (removal of the ovaries) most likely occurred in the four years preceding or following the onset of fibromyalgia pain.
This is certainly an area that requires more research. In the end, this could help us understand why 90% of fibromyalgia patients are women. Beyond that, it can reveal physiological changes that can trigger the development of the disease, which could lead to better treatments or even prevention.
For women who develop fibromyalgia after gynecological surgery, we also need to know what role, if any, surgery plays, as well as the possible roles of hormonal changes caused by surgery. Post-surgical hormone replacement therapy is also worth a look.
Doctors have long suspected that fibromyalgia has strong hormonal links and triggers. A 2013 study found links between early menopause and increased pain sensitivity in fibromyalgia patients, which may be related to lower estrogen levels.
Women with fibromyalgia are particularly prone to painful menstruation (dysmenorrhea) and some complications of pregnancy.
This study really speaks to my own experience. I was 34 years old when my youngest child was born by caesarean section and 35 years old when I stopped breastfeeding. According to my gynecologist, the hormonal changes that ensued me started in a premature perimenopause.
My menstrual cycle became irregular and the rules extremely heavy and painful, whereas they had always been regular and relatively soft. Fibromyagia symptoms quickly followed.
Six months later, I had been diagnosed and identified a pattern: my flares appeared regularly between ovulation and the beginning of my periods. My gynecologist has recommended removal of the endometrium to get rid of the hormones that are discarded by the thickening of the uterus.
Ablation not only ended the painful periods (and the rules in general), but it also alleviated my seizures and made them less numerous and more distant from each other. (Learn more about my personal Thrown Off Course: Fibromyalgia is entering my life.)
I had not had a hysterectomy, but between two pregnancies and two Caesareans, in addition to breastfeeding, my body had clearly undergone a hormonal ring.
I suspect that research will continue to demonstrate the links between fibromyalgia and hormonal changes and I hope that one day we will be much better equipped to recognize, treat and prevent hormone-related fibromyalgia.