Can Men Get Fibromyalgia?
Fibromyalgia is a widely misunderstood condition that can impact an array of bodily functions. It affects about 4 million people in the United States, according to the Centers for Disease Control and Prevention (CDC).
Can men get fibromyalgia? The short answer is "yes". In general, fibromyalgia is thought to be more common in women. Some studies, however, suggest its prevalence may be about the same in men as in women.
Research has shown that men and their healthcare providers are far less likely to identify these symptoms as fibromyalgia. One aspect of this discrepancy may be a perceived social stigma associated with a diagnosis of fibromyalgia. A perception that fibromyalgia is a "woman's disease" may cause some men to shy away from identifying it as the cause of these symptoms.
No matter what you call it, fibromyalgia and its symptoms can have profound effects on men and their sexual health. Those connections include surprising ways fibromyalgia may be related to low testosterone.
What is fibromyalgia?
At the center of the constellation of fibromyalgia symptoms is widespread musculoskeletal pain. According to Mayo Clinic, some research has shown that fibromyalgia may intensify painful sensations in some people by affecting how the brain and spinal column process both painful and nonpainful signals.
Given such a complicated condition and its broad and varied array of symptoms, it's sometimes difficult to pin down a correct fibromyalgia diagnosis.
"Fibromyalgia is more of a diagnosis of exclusion. If it's not [something else] and they have chronic pain and all these other symptoms, then they may fall under the diagnosis of fibromyalgia," said Amy Pearlman M.D., a men's health specialist and co-founder of Prime Institute in Fort Lauderdale, Florida.
In trying to understand fibromyalgia, it's important to realize it's not a condition of just the muscles or just the nervous system. It can affect any part of the body, and it needs to be addressed as such, Pearlman explained.
"It's one of those conditions, like with any chronic disease, where it's more than just the end organ that is problematic," Pearlman said. "It's a systemic problem, and with any of these systemic problems, they have to be treated systemically. Focusing on where the pain is worst is not going to treat these other symptoms."
The symptoms of fibromyalgia in men
Fibromyalgia causes chronically achy muscles and joints, fatigue, memory issues, sleep problems, issues with concentration, depression and more.
Fibromyalgia and sex
Fibromyalgia in men can have serious consequences for sexual health. It's associated with low libido, genital pain, difficulty getting aroused or reaching orgasm, and pain in the pelvic floor muscles, lower back and buttocks, all of which can interfere with sexual pleasure.
While fibromyalgia might routinely come up in a patient's conversation with a rheumatologist or a neurologist, it's interesting how often it comes up during visits with men's health specialists.
"Fibromyalgia is one of those disorders that spans specialties," said Katherine Rotker, M.D., a urologist with Yale Medicine in Connecticut who specializes in male infertility and reproductive health. "Seeing fibromyalgia patients isn't a routine part of my day, however, seeing patients who have fibromyalgia as one of their listed diagnoses is common for all physicians, myself included."
The tricky part of male fibromyalgia as it relates to erectile dysfunction (ED), for example, is that both conditions have a variety of symptoms that overlap or intersect with those of other conditions. The difficulty in pulling one thread from the overall system and saying, "This one condition caused this one symptom" is often impossible.
"In terms of sexual health, fibromyalgia is not one of these conditions where we can just do a blood test and say absolutely whether you have this or not," Rotker said. "It's a combination of many symptoms and experiences that bring that diagnosis. And many of the symptoms absolutely affect your sexual drive, as well as your ability to enjoy sexual intercourse."
Fibromyalgia and low testosterone
That brings us to one of the most interesting intersections in this story: the crossroads where Fibromyalgia Street meets Low Testosterone Lane.
When we talk about systemic problems, the array of issues that both low testosterone and fibromyalgia are associated with can cause you to do a double-take. To consider one condition without at least looking at the other would be a bit of a fool's errand.
"Symptoms that patients will report that are commonly associated with both low testosterone and fibromyalgia are things like fatigue, depression, sleep problems, memory and concentration," Pearlman said. "All of those things are the classic symptoms of low testosterone. That's not to say that every single symptom of fibromyalgia will improve if we treat them for low testosterone, but a lot of them can."
Treatment for fibromyalgia in men
Know that you can help yourself if you have fibromyalgia and sexual health issues like ED and low-T, and treatment doesn't have to involve costly, invasive procedures, either. What it may cost you is time, effort and making lifestyle choices that aren't always easy. But depending on the type of patient you are, you may find these options preferable to the potentially more expensive and invasive choices you might face in the future.
"The mainstay of treatments for fibromyalgia and other systemic disease are things people can do at home," Pearlman said. "So it's exercise and muscle strengthening and stress management and getting good sleep and doing various types of cognitive behavioral therapy."
Some people hear the recommendations and think it's great, Pearlman added. They like the fact they have a semblance of control and don't have to take medications. Other people aren't sure they can get better at all of those aspects of their life and ask if she can prescribe medications.
Fibromyalgia and ED are examples of how difficult it can be to identify a single cause for every symptom. They both demonstrate that if you improve the functioning of the overall system, you're likely to have a better chance of improving each discrete problem.
"Chronic pain is just one aspect of it," Pearlman said. "Our patients can be as simple or as complicated as we want them to be. So if we really, truly ask them what's going on, a lot of times we find out there's a lot more than what appears in their chart."