Is Menopause Making Your Fibro Worse?

by Kristin Thorson, Fibromyalgia Network Editor
Posted: June 30, 2010

If your fibromyalgia symptoms started gradually (as opposed to a sudden onset), you may have been able to deal with them during the early years. But women with fibromyalgia often notice a worsening of symptoms in their late 30s to early 40s with the onset of peri-menopausal hot flashes, night sweats, sleep disruption, daytime fatigue, and mood fluctuations.

As estrogen levels start to decline in peri-menopause and hit rock bottom in menopause, this triggers symptoms that could go untreated and might make your fibromyalgia worse. For example, the sleep complaints are very bothersome for peri-menopausal women, yet sleep studies have failed to find evidence of disturbed sleep when comparing pre-, peri-, and post-menopausal women. But what about comparing peri-menopausal women who have significant symptoms to those with very minimal symptoms? This was the basis for a research study presented at the annual SLEEP conference in San Antonio, TX, June 6-9, 2010.1

The study was very small, comparing only six women in the symptomatic group to six in the mild symptom group (i.e., controls), but here are a few of the trends that the University of Melbourne researchers identified:

  • Women in the symptomatic group had higher daytime sleepiness compared to the controls. Two validated questionnaires were used and both showed that symptomatic women are very sleepy.
  • Symptomatic women spent less time in bed than controls; the difference was almost an hour.
  • Women with lots of symptoms received less deep-level (stage 3 and 4) sleep compared to the controls. This difference was not highly significant and may go unnoticed by most sleep labs because when the overall sleep efficiency was calculated for the two groups, the results were the same.
  • The sleep in symptomatic women may not feel as refreshing or restorative as it used to be because this group of women has less parasympathetic nervous system activity during sleep. Remember, the parasympathetic system is responsible for “rest and digest” functions that should dominate during nighttime sleep. Unfortunately, this system’s activity is not normally measured during a standard sleep study (e.g., it is mostly used for research).

A much larger study involving 35 post-menopausal women who were estrogen deficient (i.e., not on hormone replacement) was presented at the same conference and the findings expand upon those in the previous study.2 The average age of the women was 54 and their overnight polysomnographic measurements revealed:

  • Average time to fall asleep was 25 minutes and the time spent awake after having fallen asleep was 52 minutes.
  • The average number of arousals during the night was 50, which helps explain why much time is spent awake.
  • The women obtained an average of only 10 minutes a night of deep-level (stage 3 and 4) sleep. This value should be closer to 45 minutes, so post-menopausal women without estrogen are truly missing out on the restorative phase of sleep. It’s also the stage of sleep that causes the release of growth hormone for repairing the tissues so this hormone may be significantly less as well.
  • The calculated sleep efficiency for the group of women was 85%. This is the cut-off for being scored as “normal” by most sleep centers, and shows how deceiving this value can be.

If your sleep is unrefreshing, whether you are an estrogen-deficient women experiencing menopausal symptoms or you are a person with fibromyalgia, a sleep study could be helpful. However, make certain that the sleep center pays special attention to the time spent in deep-level sleep and the number of arousals. The sleep efficiency of fibromyalgia patients is often graded as normal, but the actual components of your sleep could be greatly disturbed.

1. Baker F, et al. SLEEP Volume 33, Abstract 074 A28 Supplement 2010.
2. Davis E, et al. SLEEP Volume 33, Abstract 619 A208 Supplement 2010.

8 Responses to Is Menopause Making Your Fibro Worse?

  1. Mindy says:

    it is just after 4am right now..sleep..not quite sure i even know what that means..if i do sleep it is in bits and pieces of time..i wake up so often. Been in actual menopause for a year now. good article..did not know menopause was adding to fibromyalgia symptoms…definitely did not need help..enough symptoms as it is.

  2. Debbie Brooks says:

    Mindy you are not alone. Was very helpful to find menopause could have a negative effect

  3. Ina Hood says:

    I sleep as though dead! And only because of an addicting drug I started taking 20 yrs. ago for anxiety, before I had a stroke at age 44. I’m also a “had to” retired R.N.dx. with fibro in my early 30′s-back in the 70′s. I am lucky that the avm that ruptured was on my rt. side of my brain-I’m paralyzed on the left side. Walk with brace on left leg and use a cane.

  4. Ina Hood says:

    Because of stroke I have partial seizures and must take big dose of anti-seizure drug which zonks me out so I take at hs. Guess I got lucky in that dept. huh?? haha

  5. theresa says:

    i am in the same boat as mindy, and my fibro is basically untreated, i also have a bad back and rotary cuff tears in my shoulder, also arthritis justabout everywhere. i am 47 years old and in constant pain, i can only walk as far as my mailbox at any given day. i feel for everybody that i read about on this site, and the site has helped me alot. my dr does not really believe in fibro.

  6. Mindy G. says:

    I’m ANOTHER Mindy, who found this site!…I’m Perimenopausal, and also have Epilepsy, and take anti-seizure meds, and have had fibromyalgia for 30 yrs. I don’t take meds for the fibro, because I don’t like the side effects. I’m also on long term pain meds for a chronic brain disease ( I know…I sound like I’m a MESS!…Lol).

  7. Mindy G. says:

    (continute) My nights consists of NAPS only! This has made my Fibro really MUCH worse now! I don’t know WHAT to do anymore! My pain has NEVER been this bad in 30 yrs! Not sure what to do. Don’t want to take ANY more meds, especially ones to make me sleep! SO FRUSTRATING!!!

  8. Rachael says:

    I’ve had fibro for more than 20 years. As my 50th birthday approached, and a new husband, it felt as if every fibro symptom hit me at once, and with extreme force… no breaks. It was so intense at times, I felt like I would have to be sedated. I’ve had to wrap my mind around what’s happening and adjust my behavior accordingly. It’s disheartening to know that menopause causes it to get worse.

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