Why Fibromyalgia or ME/CFS May Worsen Period Pain

What's Behind Your Painful Menstrual Cramps

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Do you have period problems, like painful cramps? If so, they could be related—either directly or indirectly—to your fibromyalgia (FMS) or chronic fatigue syndrome (ME/CFS).

For women with these conditions and others related to them, painful menstrual cramps are quite common. The medical term for these painful cramps is dysmenorrhea.

We don't know exactly why dysmenorrhea is more common with FMS and ME/CFS than for those without it, but some researchers believe these three conditions—as well as several others—are all part of the same "family" of illnesses, called central sensitivity syndromes (CSS).

All of the CSS are believed to share a common underlying mechanism, and that makes it more likely that someone who has one of them will develop others. The defining quality of a CSS is a nervous system that has become sensitized to certain types of stimuli, such as touch, to the point that it mis-identifies that stimuli as dangerous or damaging to your body and responds as if it's threatened.

Even though they're related, it's still important for you to get each one diagnosed in its own right, so you can work toward proper treatment and management.

What Is Dysmenorrhea?

While dysmenorrhea is especially common in women with FMS and ME/CFS, it can happen to anyone who has menstrual periods. The cramps of dysmenorrhea can be dull or throbbing, and are usually centered in the lower abdomen. They may also cause you pain in the lower back, and some women have pain that radiates down into their thighs, as well.

The pain of dysmenorrhea can range from mildly uncomfortable all the way up to severe and debilitating. For some people, it can significantly disrupt life for a few days every month.

The type of dysmenorrhea that's been linked to FMS and ME/CFS is called "primary dysmenorrhea," meaning that it isn't due to another underlying condition.

If the cramps are caused by a condition such as endometriosis, an infection, or the presence of fibroid tumors, it's called "secondary dysmenorrhea."

However, because FMS and ME/CFS can both amplify your pain, which is called hyperalgesia, it's possible that your painful period is simply normal cramping that's basically exaggerated by your body's pain-response system. If that's the case, treatments that quiet your FMS or ME/CFS symptoms may help alleviate this period problem, as well.

Home Treatment Options for Dysmenorrhea

Often, it's possible to take care of dysmenorrhea on your own. Home treatments can include:

Remember to check with your doctor and pharmacist before starting supplements or herbal remedies.

That will help ensure that you're not taking something that will endanger your health or interact badly with other medications you're taking. (Yes, even "natural" treatments can cause unwanted side effects and interactions.)

Medical Treatments for Dysmenorrhea

If the standard home remedies don't provide enough relief for you, it's time to talk to your doctor about your symptoms.

One of the most common treatments for menstrual cramps is birth control pills or other prescription birth control methods that use hormones. These medications alter hormone levels and can lessen the symptoms caused by normal hormonal fluctuations.

(Of course, this is only an option for women who aren't pregnant or trying to get pregnant.)

However, some birth control methods are more effective against dysmenorrhea than others, so even if you're already on the pill, be sure to talk to your doctor about whether it's the best one for managing this particular symptom.

Get more information about birth control as a treatment option in this article by Verywell.com Contraception Expert Dawn Stacey: Can the Pill Treat Dysmenorrhea?

Your doctor may also prescribe antidepressants, prescription NSAIDs or other painkillers such as opiates (for a short period of time.)

Some research shows that acupuncture can be helpful as well.

When considering treatments, your doctor may want to look at whether your FMS or ME/CFS symptoms appear to be connected to your menstrual cycle and whether your periods changed after the onset of FMS or ME/CFS. That doesn't happen to all women with these conditions, but it's common enough to warrant a look. You might want to keep a symptom log or journal to track your symptoms and look for any correlation between bad days and your cycle.

A Word From Verywell

It's important to remember that while dysmenorrhea may be related to FMS and ME/CFS, it's a separate condition that needs to be managed separately. However, some treatments may have crossover value for your various conditions. These include pain relievers, antidepressants, stress relief, supplements, and acupuncture.

Dysmenorrhea isn't the only period problem those of us with these conditions can face. In fact, multiple issues tied to female hormones are more common alongside FMS and ME/CFS than in the general population.

Sources:

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Harel Z. Dysmenorrhea in adolescents and young adults: an update on pharmacological treatments and management strategies. Expert opinion on pharmacotherapy. 2012 Oct;13(15):2157-70.

Liu YQ, Ma LX, Xing JM, et al. Does traditional Chinese medicine pattern affect acupoint specific effect? Analysis of data from a multicenter, randomized, controlled trial for primary dysmenorrhea. Journal of alternative and complementary medicine. 2013 Jan;19(1):43-9.

Smith HS, Harris R, Clauw D. Pain physician. Fibromyalgia: an afferent processing disorder leading to a complex pain generalized syndrome. 2011 Mar-Apr;14(2):E217-45.

Song JS, et al. Survey on the evaluation indices of acupuncture clinical trials for primary dysmenorrhea in recent 10 years. Chinese acupuncture & moxibustion. 2012 Feb;32(2):187-90. Article in Chinese. Abstract referenced.