By Dr Ananya Mandal, MD
Fibromyalgia is a complex condition with multiple symptoms including wide spread tender point pain, fatigue, headaches, confusion or cognitive loss, migraine and other headaches, irritable bowel syndrome, non-restorative sleep etc.
Due to its multiple and variable symptoms, the condition is difficult to diagnose and treat. Further there are no confirmatory and specific tests or imaging studies that can diagnose this condition with conviction.
The condition affects around 10 million people and is seven to nine times more common in females than in males. The condition has no cure and the symptoms make the sufferer severely debilitated.
Clinical differences of fibromyalgia in men and women
There are differences between men and women when it comes to the manifestation of fibromyalgia. These include the level of autonomic dysfunction and interaction between the sympathetic and parasympathetic systems in postural change along with heart rate variability.
A recent study shows that men with fibromyalgia while at rest have sympathetic system over-activity while their parasympathetic system is underactive. Male patients, when their posture is changed, show an abnormal sympathetic and vagal response as well. This could lead to imbalances created due to posture changes.
Under-diagnosis among men with fibromyalgia
Since fibromyalgia is difficult to diagnose and men get it so infrequently, the condition goes largely unnoticed and is under-diagnosed among men.
A recent study in the Journal Arthritis Care and Research revealed the under-diagnosis of this condition among men. The researchers looked at adults in Olmsted County, Minn., who could be having fibromyalgia. On using the American College of Rheumatology criteria for diagnosis it was noted that around 6.4% had definite fibromyalgia while official figures are around 3% or less meaning, many of the cases go undiagnosed.
The study further showed that symptoms matching with fibromyalgia are seen in more men not diagnosed with fibromyalgia compared to women. Thus diagnosis is being missed twenty times in men compared to three times in women.6
Men with fibromyalgia and health care utilization
Health care utilization is higher among those with fibromyalgia. The disease being perceived as a psychological one makes seeking help an embarrassment with fears of not being taken seriously.
Among men, common fears regarding use of health care facilities include “being perceived a whiner”, being neglected or used as an experimental animal, being frustrated for not finding a sympathetic listener and not getting an actual cure.
The barriers in perception make men with fibromyalgia wait longer than women before treatment at a specialist clinic is obtained.
Further men fail to get follow-ups in primary care and general hospitals.
Reviewed by April Cashin-Garbutt, BA Hons (Cantab)
Last Updated: Jul 31, 2013