Skip to main content

Advertisement

SpringerLink
Log in

The role of gender in fibromyalgia syndrome

  • Published:
Current Rheumatology Reports Aims and scope Submit manuscript

Abstract

Fibromyalgia syndrome (FMS), characterized by widespread pain and tenderness on palpation (tender points), is much more common in women than in men in a proportion of 9:1. Two recent studies have shown important gender differences in various clinical characteristics of FMS. In a community and a clinic sample, women experienced significantly more common fatigue, morning fatigue, hurt all over, total number of symptoms, and irritable bowel syndrome. Women had significantly more tender points. Pain severity, global severity and physical functioning were not significantly different between the sexes, nor were psychologic factors, eg, anxiety, stress, and depression. Gender differences have also been observed in other related syndromes, eg, chronic fatigue syndrome, irritable bowel syndrome, and headaches. The mechanisms of gender differences in these illnesses are not fully understood, but are likely to involve an interaction between biology, psychology, and sociocultural factors.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References and Recommended Reading

  1. Collins SD: Cases and days of illness among males and females, with special reference to confinement in bed. Pub Health Rep 1940, 55:47–93.

    Google Scholar 

  2. Downes J: Cause of illness among males and females. Milbank Mem Fund Q 1950, 28:407–428.

    Article  PubMed  CAS  Google Scholar 

  3. Katz PP, Criswell LA: Differences in symptom reports between men and women with rheumatoid arthritis. Arthritis Care Res 1996, 9:441–448.

    Article  PubMed  CAS  Google Scholar 

  4. Font J, Cervera R, Navarro M, et al.: Systemic lupus erythematosus in men: clinical and immunological characteristics. Ann Rheum Dis 1992, 51:1050–1052.

    PubMed  CAS  Google Scholar 

  5. Resnick D, Dwosh IL, Goergen TG, et al.: Clinical and radiographic abnormalities in ankylosing spondylitis: a comparison of men and women. Radiology 1976, 119:293–297.

    PubMed  CAS  Google Scholar 

  6. Puig JG, Michan AD, Jimenez ML, et al.: Female gout. Arch Int Med 1991, 151:726–732.

    Article  CAS  Google Scholar 

  7. Yunus MB, Masi AT, Calabro JJ, Miller KA, Feigenbaum SL: Primary fibromyalgia (fibrositis): clinical study of 50 patients with matched normal controls. Semin Arthritis Rheum 1981, 11:151–171.

    Article  PubMed  CAS  Google Scholar 

  8. Wolfe F, Smythe HA, Yunus MB, et al.: The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia. Report of the Multicenter Criteria Committee. Arthritis Rheum 1990, 33:160–172.

    Article  PubMed  CAS  Google Scholar 

  9. Bengtsson A, Henriksson KG, Jorfeldt L, Kagedal B, Lennmarken C, Lindstrom F: Primary fibromyalgia: a clinical and laboratory study of 55 patients. Scand J Rheumatol 1986, 15(3):340–347.

    PubMed  CAS  Google Scholar 

  10. Nishikai M: Fibromyalgia in Japanese. J Rheumatol 1992, 19:110–114.

    PubMed  CAS  Google Scholar 

  11. Choudhury AK, Yunus MB, Haq SA, Alam MN, Sebrina F, Aldag JC: Clinical features of fibromyalgia syndrome in a Bangladeshi population. J Musculoskele Pain, in press.

  12. Wolfe F, Ross K, Anderson J, Russell IJ, Herbert L: The prevalence and characteristics of fibromyalgia in the general population. Arthritis Rheum 1995, 38(1):19–28.

    Article  PubMed  CAS  Google Scholar 

  13. White KP, Speechley M, Harth M, Ostbye T: The London Fibromyalgia Epidemiology Study: the prevalence of fibromyalgia syndrome in London, Ontario. J Rheumatol 1999, 26(7):1570–1576.

    PubMed  CAS  Google Scholar 

  14. Wolfe F, Ross K, Anderson J, Russell IJ: Aspects of fibromyalgia in the general population: sex, pain threshold, and fibromyalgia symptoms. J Rheumatol 1995, 22(1):151–156. Article with data-based information on gender differences in the clinical characteristics of fibromyalgia syndrome.

    PubMed  CAS  Google Scholar 

  15. Yunus MB, Inanici F, Aldag JC, Mangold RF: Fibromyalgia in men: comparison of clinical features with women. J Rheumatol 2000, 27(2):485–490. Article with data-based information on gender differences in the clinical characteristics of fibromyalgia syndrome.

    PubMed  CAS  Google Scholar 

  16. Inanici F, Yunus MB, Aldag JC: Psychological features in men with fibromyalgia syndrome. Annals Rheum Dis 2000, 59(suppl 1):62.

    Google Scholar 

  17. Buskila D, Neuman L, Alhoashle A, Abu-Shakra: Fibromyalgia syndrome in men. Semin Arthritis Rheum 2000, 47–51. Article with data-based information on gender differences in the clinical characteristics of fibromyalgia syndrome.

  18. Yunus MB, Masi A, Aldag JC: A controlled study of primary fibromyalgia syndrome: clinical features and association with other functional syndromes. J Rheumatol (Suppl) 1989, 19:62–71.

    CAS  Google Scholar 

  19. Hudson JI, Pope HG: Fibromyalgia and psychopathology: is fibromyalgia a form of affective spectrum disorder? J Rheumatol (Suppl) 1989, 19:15–22.

    CAS  Google Scholar 

  20. Yunus MB: Psychological aspects of fibromyalgia syndrome: a component of the dysfunctional spectrum syndrome. Bailliere’s Clin Rheumatol 1994, 8(4):811–837.

    Article  CAS  Google Scholar 

  21. Yunus MB: Central sensitivity syndromes: a unified concept for fibromyalgia and other similar maladies. J Indian Rheum Assoc 2000, 8(1):27–33. This article suggests a unifying model for fibromyalgia syndrome and related syndromes with a proposed common pathophysiological mechanism, which may be of importance in studies of gender differences in these syndromes.

    Google Scholar 

  22. Yunus MB, Masi AT: Association of primary fibromyalgia with stress-related syndromes (abstract). Clin Res 1985, 33(4):917A.

    Google Scholar 

  23. Bennett RM: Emerging concepts in the neurobiology of chronic pain: evidence of abnormal sensory processing in fibromyalgia. Mayo Clinic Proceedings 1999, 74(4):385–398.

    Article  PubMed  CAS  Google Scholar 

  24. Drossman DA, Sandler RS, McKee DC, Lovitz AJ: Bowel patterns among subjects not seeking health care. Gastroenterology 1982, 83:529–534.

    PubMed  CAS  Google Scholar 

  25. Kruis W, Thieme CH, Weinzier M, Schussler P, Holl J, Paulus W: A diagnostic score for the irritable bowel syndrome. Gastroenterology 1984, 87:1–7.

    PubMed  CAS  Google Scholar 

  26. Gwee KA: The role of psychological and biological factors in postinfective gut dysfunction. Gut 1993, 44:400–406.

    Article  Google Scholar 

  27. Smith RC, Greenbaum DS, Vancouver JB, et al.: Gender differences in Manning criteria in irritable bowel syndrome. Gastroenterology 1991, 100:591–595.

    PubMed  CAS  Google Scholar 

  28. Thompson WG: Gender difference in irritable bowel syndrome. Eur J Gastroenterol Hepatol 1997, 9:299–302.

    PubMed  CAS  Google Scholar 

  29. Diamond S, Dalessio DJ: The Practicing Physician’s Approach to Headache. Baltimore: Williams & Wilkins, 1986:66–75.

    Google Scholar 

  30. Rasmussen BK, Jensen R, Schroll M, Olesen J: Epidemiology of headache in a general population—a prevalence study. J Clin Epidemiol 1991, 44:1147–1157.

    Article  PubMed  CAS  Google Scholar 

  31. Rasmussen BK: Epidemiology of headache. Cephalalgia 1995, 14:45–68.

    Google Scholar 

  32. Stewart WF, Lipton RB, Simon D: Work-related disability: results from the American Migraine Study. Cephalalgia 1996, 16:231–238.

    Article  PubMed  CAS  Google Scholar 

  33. Celentano DD, Linet MS, Stewart WF: Gender differences in the experience of headache. Soc Sci Med 1990, 30:1289–1295.

    Article  PubMed  CAS  Google Scholar 

  34. Panconesi A, Curradi C, Anselmi B, Franchi G: Sex difference in headache sufferers’ responsiveness to painful over distension of the hand-forearm veins. Funct Neurol 1994, 9:133–139.

    PubMed  CAS  Google Scholar 

  35. Buchwald D, Perlman T, Kith P, Schmaling K: Gender differences in patients with chronic fatigue syndrome. Gen Intern Med 1994, 9:397–401. Data-based article on gender differences in the clinical characteristics of chronic fatigue syndrome, which is closely related to fibromyalgia syndrome.

    Article  CAS  Google Scholar 

  36. Fillingim R: Sex, gender and pain: a biopsychosocial framework. In Sex, Gender and Pain. Edited by Fillingim RB. Seattle: IASP Press; 2000:1–6.

    Google Scholar 

  37. Fillingim RB, Maixner W: Gender differences in the responses to noxious stimuli. Pain Forum 1995, 4:209–221. An excellent review article on gender differences in experimental pain.

    Google Scholar 

  38. Mogil JS: Interrelations between sex and genotype in the mediation and modulation of nociception in rodents. In Sex, Gender and Pain. Edited by Fillingim RB. Seattle: IASP Press; 2000:25–40.

    Google Scholar 

  39. Fillingim RB, Maixner W, Kincaid S. Silva S: Sex differences in temporal summation but not sensory-discriminative processing of thermal pain. Pain 1998, 75:121–127.

    Article  PubMed  CAS  Google Scholar 

  40. Nishisawa S, Benkelfats C, Young SN, et al.: Differences between males and females in rates of serotonin synthesis in human brain. Proc Natl Acad Sci USA 1997, 94:5308–5313.

    Article  Google Scholar 

  41. Sternberg W: Animal models of sex differences in pain and analgesia. J Musculoskele Pain 1998, 6:37–40.

    Article  Google Scholar 

  42. Kiefel JM, Bodnar RJ: Roles of gender and gonadectomy in pilocrapine and clonidine analgesia in rats. Pharmacol Biochem Behav 1991, 41:153–158.

    Article  Google Scholar 

  43. Aloisi AM, Albonetti ME, Carli G: Sex differences in the behavioral response to persistent pain in rats. Neurosci Lett 1994, 179:79–82.

    Article  PubMed  CAS  Google Scholar 

  44. Kavaliers M, Galea LAM: Sex differences in the expression and antagonism of swim stress-induced analgesia in deer mice vary with the breeding season. Pain 1995, 63:327–334.

    Article  PubMed  CAS  Google Scholar 

  45. Cicero TJ, Nock B, Meyer ER: Sex-related differences in morphine’s antinociceptive activity: relationship to serum and brain morphine concentrations. J Pharmacol Exp Ther 1997, 282:939–944.

    PubMed  CAS  Google Scholar 

  46. Aloisi AM: Sensory effects of gonadal hormones. In Sex, Gender and Pain. Edited by Fillingim RB. Seattle: IASP Press; 2000:7–24.

    Google Scholar 

  47. Bethea CL, Pecins-Thompson M, Schutzer WE, Gundlah C, Lu ZN: Ovarian steroids and serotonin neural function. Mol Neurobiol 1998, 18:87–123.

    Article  PubMed  CAS  Google Scholar 

  48. Hapidou EG, Rollman GB: Menstrual cycle modulation of tender points. Pain 1998, 77:151–161.

    Article  PubMed  CAS  Google Scholar 

  49. Dessein PH, Shipton EA, Joffe BI, et al.: Hyposecretion of adrenal androgens and the relation of serum adrenal steroids, serotonin and insulin-like growth factor-1 to clinical features in women with fibromyalgia. Pain 1999, 83:313–319.

    Article  PubMed  CAS  Google Scholar 

  50. Lacroix R, Barbaree HE: 50. Lacroix R, Barbaree HE: The impact of recurrent headaches on behavior lifestyle and health. Behav Res Ther 1990, 28(3):235–242.

    Article  PubMed  CAS  Google Scholar 

  51. Gilbar O, Bazak Y, Harel Y: Gender, primary headache, and psychological distress. Headache 1998, 38:31–34.

    Article  PubMed  CAS  Google Scholar 

  52. Nolen-Hoeksema S: Sex Differences in Depression. Stanford: Stanford University Press, 1990.

    Google Scholar 

  53. Unruh AM, Ritchie J, Merskey H: Does gender affect appraisal of pain and pain coping strategies? Clin J Pain 1999, 15:31–40.

    Article  PubMed  CAS  Google Scholar 

  54. Mechanic D: The influence of mothers on their children’s health attitudes and behavior. Pediatrics 1964, 33:444–453.

    PubMed  CAS  Google Scholar 

  55. Savedra M, Gibbons P, Tesler M, Ward J, Wegner C: How do children describe pain? A tentative assessment. Pain 1982, 14:95–104.

    Article  PubMed  CAS  Google Scholar 

  56. Levine FM, De Simone LL: The effects of experimenter gender on pain report in male and female subjects. Pain 1991, 44:69–72.

    Article  PubMed  CAS  Google Scholar 

  57. Jensen I, Nygren A, Gamberale F, Goldie I, Westerholm P: Coping with long-term musculoskeletal pain and its consequences: is gender a factor? Pain 1994, 57:167–172.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. College of Medicine at Peoria, University of Illinois, One Illini Drive, PO Box 1649, 61656, Peoria, IL, USA

    Muhammad B. Yunus MD

Authors
  1. Muhammad B. Yunus MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Yunus, M.B. The role of gender in fibromyalgia syndrome. Curr Rheumatol Rep 3, 128–134 (2001). https://doi.org/10.1007/s11926-001-0008-3

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11926-001-0008-3

Keywords

Search

Navigation