Can Estrogen Help Fibromyalgia Pain?

Estrogen supplementation during peri- and post-menopause in women with fibromyalgia is thought to be beneficial, but does it really work to reduce widespread pain? According to a just-published study by a Swedish team lead by Anders Blomqvist, M.D., it turns out that taking supplemental estrogen in post-menopausal women with fibromyalgia will not ease your pain.*

Blomqvist and colleagues decided to put estrogen to the test. It’s commonly assumed that estrogen replacement helps with the pain processing system in the body to reduce fibromyalgia discomfort. Yet this is just a theory endorsed by many in the medical community without any concrete proof.

Half of the 49 to 60-year-old women in Blomqvist’s study were treated for eight weeks with an estrogen patch (delivering 17 beta-estradiol, the natural form of this hormone), and the other half were treated with a placebo, look-alike patch. Numerous measures of pain sensory levels were taken before the trial, after the eight-week trial period, and 20 weeks after the end of the trial. These tests were selected because people with fibromyalgia have an amplified sensory system in which the pain volume in the central nervous system is abnormally high. This means that light touch or slight changes in temperature are more readily perceived as painful.

If estrogen replacement therapy actually reduced fibromyalgia pain, it should decrease the pain volume, and this will be picked up by the many different tests that were done on all of the trial subjects. For example, the amount of pressure applied before the subjects detected it as painful should increase in the estrogen group. In addition, the length of time that subjects could immerse their hand in icy-cold water before it became uncomfortable should increase.

“Our data show that estrogen treatment does not alleviate pain in post-menopausal women with fibromyalgia,” Blomqvist says. In other words, none of the pain sensory tests were improved by the estrogen.

If you are shaking your head at the results of this trial, Blomqvist states, “The present study did not monitor potential beneficial effects of estrogen treatment on symptoms of fibromyalgia not directly related to pain.” He adds that sleep, hot flashes (vasomotor symptoms), anxiety, mood, or general quality of life may be eased by estrogen replacement. In fact, our June 30, 2010 Latest News describes two trials showing that estrogen supplementation reduces sleep disruption and next-day fatigue in peri- and post-menopausal women. However, neither of these studies involved fibromyalgia patients, so they did not evaluate estrogen’s impact on pain.

“Any beneficial effects of estrogen on fibromyalgia are likely not related to reduction of pain,” writes Blomqvist. But he adds that additional studies looking at estrogen’s effect on other fibromyalgia symptoms may still be of interest.

If you are a woman with fibromyalgia on estrogen replacement therapy, make sure you understand why. If the reason is because you were hoping the hormone would reduce your pain, talk to your doctor because you may want to see how you do without the hormone. However, if you are taking estrogen because of hot flashes, sleep disruption (and the resulting daytime fatigue it can cause), anxiety, or mood, this study does not refute the hormone’s role in easing these symptoms. Due to the potential risks of long-term use, such as breast cancer and cardiovascular problems, research reports that help clarify the most likely benefits of estrogen are always valuable.

* Stening KD, et al. Rheumatology [Epub ahead of print] November 14, 2010.