Women with fibromyalgia report significant pelvic floor and urinary symptoms, says survey
Researchers at Oregon Health & Science University have found that disease severity in women with fibromyalgia is linked to increased urinary symptoms and problems related to the pelvic floor.
Researchers noted that fibromyalgia is a common, debilitating disorder of widespread pain affecting an estimated 5 million people in the US. Similarly, chronic pelvic pain is estimated to affect at least 9 million women, and 4 to 7 million women report bladder pain/interstitial cystitis symptoms.
The study says that, given that these three chronic pain syndromes are highly prevalent, it is not surprising that they often coexist and that people with fibromyalgia often report numerous regional pain syndromes, including headaches, temporomandibular disorders, low back/neck pain, myofascial pain, irritable bowel, pelvic pain and bladder pain.
The purpose of the study was to characterise pelvic floor and urinary symptoms in women with fibromyalgia and to describe the strength of the relationship between pelvic floor symptoms and urinary symptoms with the total impact of fibromyalgia.
Like fibromyalgia, pelvic pain and bladder pain have been characterised by some as functional or sensory hypersensitivity pain disorders for which there are conflicting theories as to the cause and there is lack of standardised treatment. Pelvic floor disorders negatively influence a woman’s activities of daily living, sexual function, bowel and bladder function and overall quality of life and yet despite their high prevalence and negative impact, the researchers say that little is known about the relationship between pelvic/bladder symptoms and fibromyalgia severity.
The study, which was published in Pain Management Nursing, conducted a survey of 204 women with fibromyalgia, and 177 completed all three questionnaires included in the survey.
Participants were composed of women with moderate to severe fibromyalgia and most had reported having experienced fibromyalgia symptoms for more than ten years.
The first questionnaire, the Revised Fibromyalgia Impact Questionnaire, examined current levels of negative impact from fibromyalgia symptoms divided into three categories: level of function, overall impact, and symptoms. The other two questionnaires, the Pelvic Pain, Urgency and Frequency Questionnaire and the Pelvic Floor Distress Inventory 20 (PFDI-20), examined pelvic floor symptoms.
The research team was led by Kim Dupree Jones. They found that patients scored relatively high on the PFDI questionnaire, with colorectal distress being the most troublesome symptom group.
Almost all, (93%), of the women reported experiencing bladder or pelvic pain at least occasionally, and more than half had continuous symptoms. The same amount of women also reported feelings of urinary urgency after urination and more than half of them said this was a common symptom for them.
It was also noted that when the fibromyalgia symptoms were more severe, the pelvic and urinary symptoms also tended to be high. Researchers said that their findings may contribute to a growing body of literature suggesting that pelvic floor distress could play a significant role in fibromyalgia as a potential pain generator that perpetuates and exacerbates chronic pain and heightened sensitivity to pain.
The study concludes that doctors treating fibromyalgia patients need to be aware that pelvic distress and urinary symptoms increase with more severe fibromyalgia and that they should also evaluate and treat pelvic floor and urinary symptoms in their patients as part of a complete disease management.
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