Fibromyalgia and Hormone Replacement Therapy
Fibromyalgia affects far more women than men. This fact has led many people to wonder whether hormones play a part in the development of this painful condition. If so, it seems logical that hormone replacement therapy (HRT) could help, but is there any truth to this theory?
In this article we look at the relationship between fibromyalgia and hormones, and whether HRT could help.
Can Hormone Replacement Therapy Help Fibromyalgia?
As many as 80-90% of people with fibromyalgia are women. Furthermore, the condition is often diagnosed between the ages of 30 and 50, a period which coincides with the onset of menopause.
Many of the symptoms of fibromyalgia are also similar to those of the menopause. These symptoms include:
- Stiffness, aches and pains
- Poor sleep
- Daytime fatigue
- Mood changes
- Difficulty with concentration and memory
This has led many people to speculate that hormonal changes could play a role in the development of fibromyalgia. It has also led scientists to wonder whether HRT could help.
The current evidence for using HRT to treat fibromyalgia is inconclusive. One study found that treatment with estrogen-based HRT did not lead to any improvements in fibromyalgia pain. However, the authors state that HRT could help with other symptoms such as sleep, vasomotor symptoms (e.g. hot flashes), mood and overall quality of life.
Another study found that hormonal treatment does offer pain relief to fibromyalgia patients. However, the hormone used in the study was testosterone rather than estrogen. The study found that using testosterone as a gel significantly reduced pain and the sensitivity of tender points.
To explain the results of these two studies, let’s look at the link between hormones and fibromyalgia.
The Relationship between Hormones and Fibromyalgia
It is still unclear why some people develop fibromyalgia, but it is thought to be due to an imbalance in the body’s pain processing system. Pain is controlled by a complex interaction between nerve cells, hormones and other chemicals. If any of these factors is thrown out of harmony, pain can occur.
In terms of hormones, it seems that testosterone and progesterone have the most significant impact on pain. Increased levels of both of these hormones are associated with decreases in pain. Estrogen appears to play a less significant role. However, estrogen does have a close relationship with serotonin, a neurotransmitter that is often decreased in fibromyalgia patients.
The exact relationship between hormones and fibromyalgia is yet to be fully established. However, what we do know is that men with the condition tend to report less pain than women, suggesting that hormones do play a role.
It also seems that fibromyalgia may make menopausal symptoms worse. One study found that of the post-menopausal women who experienced symptoms, 29% were also diagnosed with fibromyalgia. In comparison, only 4% of the women without symptoms had a fibromyalgia diagnosis.
Fibromyalgia and Hormone Replacement Therapy Benefits
There are many different types of HRT. Some contain estrogen alone while others contain estrogen combined with progesterone. These medications are available as tablets, patches, or topical creams and gels.
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Although research suggests that estrogen-based HRT probably does not help with fibromyalgia pain, it could still have several benefits. HRT can help to reduce hot flashes, improve sleep and regulate your mood.
If you are suffering from fibromyalgia, the last thing you need is menopause symptoms on top, so this could be a real plus. Women who take HRT may also experience improvements in their energy levels and sex drive.
Another benefit of HRT is that it could help reduce the risk of heart disease and osteoporosis. These conditions are more common after menopause due to decreases in estrogen levels. However, these benefits need to weighed carefully against the risks.
Fibromyalgia and Hormone Replacement Therapy Risks
There are certain risks associated with taking HRT, especially if you take it for a long time. Women who take HRT for longer than a year may have an increased risk of breast cancer, and possibly a slightly increased risk of ovarian cancer.
Estrogen-only HRT is associated with an increased risk of uterine (womb) cancer, although combined HRT reduces this risk. Therefore, medication containing both estrogen and progesterone is usually recommended, unless you have had a hysterectomy.
Another possible risk of HRT is an increased chance of developing blood clots. However, menopausal women are at very low risk of this problem, so it is not considered a major concern.
Finally, estrogen-only HRT can slightly increase the risk of having a stroke, but again, the risk is still relatively low.
Aside from these risks, taking HRT can cause several other side effects. Although most of these are not serious, they can be annoying nonetheless.
The side effects of HRT include:
- Bloating
- Breast tenderness
- Nausea
- Leg cramps
- Headaches and migraines
- Indigestion
- Vaginal bleeding
- Mood swings or depression
These side effects will vary depending on which type of HRT you take. They are less likely to occur if you use patches or topical creams.
Fibromyalgia and Hormone Replacement Therapy: The Bottom Line
If you are thinking about using HRT to treat fibromyalgia, you will need to decide whether the potential benefits outweigh the risks. You also need to consider which symptoms you are hoping to relieve.
If you want to treat your sleep, anxiety or menopausal symptoms, HRT could help. However, if you are looking for pain relief, other medications may be more beneficial. Discuss the options with your physician to try and find the most appropriate therapy for you.
