Symptomatology of Fibromyalgia Syndrome in Men: A Mixed-Method Pilot Study

Abstract

Fibromyalgia syndrome (FMS) is characterized by generalized chronic musculoskeletal pain, fatigue, and sleep disturbance, as well as cognitive, somatic, and other symptoms. Most people affected by FMS are women, and studies analyzing this condition in men are scarce. In this study, we discuss the physical and psychological symptoms of FMS in men, analyze the possible side effects of pharmacological therapies, and explore the impact of the illness comparing these results between the different classification groups according to sociodemographic variables (marital status, level of education, employment situation and number of people living at home). We used a sequential exploratory mixed method (MM). Qualitative information was obtained from two focus groups (n = 10). Structured questionnaires were administered to 23 men affected by FMS. The mean age of the participants was 51.7 years (SD = 9.64). The most common drugs used were antidepressants and anxiolytics (86.9%), followed by non-steroidal anti-inflammatory drugs (82.6%) and opioids (60.9%). Current level of pain was high (8.2; SD = 1.1), while perceived health and satisfaction with pharmacological treatments were low (4.6; SD = 2.6 and 3.5; SD = 3.2, respectively). The impact of FMS measured using the Fibromyalgia Impact Questionnaire (FIQ) was very high at 88.7 (SD = 8.2). Six categories related with symptoms and side effects of the medication were observed in the qualitative data: (1) main physical symptoms, (2) mood disorders, (3) insomnia and non-restorative sleep, (4) cognitive disturbance, (5) hypersensitivity, and (6) symptoms secondary to opioids. Pain and fatigue were the symptoms most often mentioned by the participants (70% and 80%, respectively). Other important symptoms were anxiety, depression, and memory and sleep disorders. The consumption of opioids causes further unwanted symptoms such as drowsiness and dependence, which makes it difficult for patients to perform basic everyday activities. We believe it is vitally important to continue investigating this symptomatology in order to improve diagnosis and treatment for these patients.

Emotional experiences and gender roles of men with fibromyalgia syndrome: a cross-cultural qualitative study

“…The Spanish health and social system provide healthcare coverage and pension provision (27). Participants in our study also identified negative emotions like anger, frustration, and impotence experiences with the misunderstandings by some healthcare professionals with did not contribute to their improvement (11,22,23). The misunderstanding of the disease and lack of empathy on the part of family, friends, and health professionals caused emotions of anger, rage, frustration, and helplessness (11,25).…”

“…Participants in our study also identified negative emotions like anger, frustration, and impotence experiences with the misunderstandings by some healthcare professionals with did not contribute to their improvement (11,22,23). The misunderstanding of the disease and lack of empathy on the part of family, friends, and health professionals caused emotions of anger, rage, frustration, and helplessness (11,25). Also, men reported the lack of recognition of FMS in men has such a strong influence on men who are affected because it is not believed that men can suffer from it, as it is mostly associated with the female sex (35).…”

“…Hopefully, these attitudes are changing (9). Gender differences have been difficult to study because of relatively fewer men being diagnosed with FMS (10)(11)(12)(13). There is a high prevalence of pain, fatigue, and other common FMS symptoms among women, while the frequency of neuropsychiatric symptoms is higher among men (14).…”

Patients’ Lived Experience in a Multicomponent Intervention for Fibromyalgia Syndrome in Primary Care: A Qualitative Interview Study

“…On the other hand, this sex bias may also affect men by being underdiagnosed which delays assessing the peculiarities of FMS in this population and its best treatment approach [ 13 , 66 ]. Studies on men’s illness experience with FMS have found some differences with women’s symptomatology [ 66 , 67 , 68 ]. For instance, Miró and colleagues [ 66 ] found that emotional distress and sleep disorders affect cognitive functions differently between sex.…”

A web-based educational therapy intervention associated with physical exercise to promote health in fibromyalgia in Brazil: the Amigos De Fibro (Fibro Friends) study protocol

“…In addition, in urban areas, prevalence reaches 0.7 and 11.4%, and in rural areas between 0.1 and 5.2% [ 3 ]. Studies also point to the presence of fibromyalgia in men [ 4 – 6 ]. Although the prevalence of fibromyalgia does not have the same notoriety as other rheumatologic conditions, its annual economic impact is considered very high [ 7 , 8 ].…”