Kliniska forskningsresultat: Fibromyalgi relaterad till hysterektomi, gynekologisk sjukdom: även relaterad till endokrina och autoimmuna störningar

Har du genomgått en gynekologisk operation, såsom en hysterektomi, några år före starten av fibromyalgi?

Vissa människor har märkt denna trend och en studie som publicerades 2015 fastslår sambandet mellan dessa typer av operationer och utseendet av fibromyalgi. Det ger också ytterligare bevis på en association mellan fibromyalgi och överlappande, gynekologiska, endokrina eller autoimmuna tillstånd.

resultat

Som en del av studien undersökte forskare rekord av 219 kvinnor med fibromyalgi och 116 kvinnor med kronisk smärta andra än fibromyalgi. Specifikt undersökte de tiden som löpte mellan sjukdomsuppkomsten och gynekologisk operation, liksom antalet överlappande sjukdomar i varje grupp.

De fann också att var och en av de tre typerna av diagnos som studerades var oberoende av fibromyalgi. Sköldkörtelsjukdom och gynekologisk kirurgi var signifikant vanligare hos kvinnor med fibromyalgi än hos andra typer av kronisk smärta.

Tidpunkten för gynekologisk kirurgi i samband med smärtinfarkt var särskilt intressant. De hittade mer kirurgi under åren före starten av fibromyalgi-relaterad smärta eller året efter att smärtan började. Denna modell var unik för gruppen fibromyalgi.

Vid första anblicken kan det tyckas konstigt att gynekologiska operationer som utförts under året efter att smärtan uppstått anses vara relaterad till utvecklingen av fibromyalgi.

En sådan förening kan emellertid bero på flera relevanta faktorer.

Tänk exempelvis att många kvinnor har gynekologiska problem länge innan de väljer operation som behandling av val. Hormonala förändringar eller gynekologiska sjukdomar kan vara riskfaktorer för fibromyalgi på grund av ett underliggande förhållande som vi ännu inte förstår.

Enligt studien uppträdde hysterektomier och ovariektomier (avlägsnande av äggstockarna) sannolikt under de fyra år som föregår eller efter starten av fibromyalgi smärta.

Det här är verkligen ett område som kräver mer forskning. I slutändan kan detta hjälpa oss att förstå varför 90% av fibromyalgi patienter är kvinnor. Utöver det kan det avslöja fysiologiska förändringar som kan utlösa utvecklingen av sjukdomen, vilket kan leda till bättre behandlingar eller till och med förebyggande.

För kvinnor som utvecklar fibromyalgi efter gynekologisk kirurgi, behöver vi också veta vilken roll, om någon kirurgi spelar, samt möjliga roller av hormonella förändringar orsakade av operation. Post-kirurgisk hormonersättningsterapi är också värt en titt.

Föregående sökning

Läkare har länge misstänkt att fibromyalgi har länkar och starka hormonella triggers. En studie 2013 fann länkar mellan tidig menopaus och ökad känslighet för smärta i fibromyalgipatienter, som kan vara relaterat till den minskade östrogennivåer.

Kvinnor med fibromyalgi är särskilt benägna att smärta menstruation (dysmenorré) och några komplikationer av graviditet.

Min erfarenhet

Denna studie talar verkligen till min egen erfarenhet. Jag var 34 år när mitt yngsta barn föddes av kejsarsnitt och 35 år när jag slutade amma. Enligt min gynekolog startade de hormonella förändringar som följde mig i en för tidig perimenopause.

Min menstruationscykel blev oregelbunden och reglerna var extremt tunga och smärtsamma, medan de alltid hade varit regelbundna och relativt mjuka. Fibromyagia symptom följde snabbt.

Sex månader senare hade jag diagnostiserats och identifierat ett mönster: Mina blöjor uppträdde regelbundet mellan ägglossningen och början av mina perioder. Min gynekolog har rekommenderat avlägsnande av endometrium för att bli av med de hormoner som kasseras genom livmoderns förtjockning.

Ablation slutade inte bara de smärtsamma perioderna (och reglerna i allmänhet), men det lindrade också mina anfall och gjorde dem mindre talrika och mer avlägsna från varandra. (Läs mer om min personliga bortkastad kurs: Fibromyalgi går in i mitt liv.)

Jag hade inte haft en hysterektomi, men mellan två graviditeter och två kejsarsnitt, förutom amning, hade min kropp tydligt genomgått en hormonell ring.

Jag misstänker att forskningen fortsätter att demonstrera sambandet mellan fibromyalgi och hormonella förändringar och jag hoppas att vi en dag kommer att vara mycket bättre rustade att känna igen, behandla och förebygga hormonrelaterad fibromyalgi.

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