April 16, 2010 (Toronto) — Symptoms of irritable bowel syndrome (IBS),fibromyalgia, and a painful bladder condition called interstitial cystitis (IC)seem to get worse in some women right before and during menstruation,researchers report.
All three are disorders of the autonomic nervous system. That’s the part ofthe brain, spinal cord, and nerves that controls functions such as bloodpressure and bladder control; these functions are largely involuntary and belowour level of consciousness.
“Since other autonomic disorders like migraine and fainting seem to havemenstrual variations, we theorized that these conditions would have thesevariations as well,” says Thomas Chelimsky, MD, professor of neurology at CaseWestern Reserve University in Cleveland.
IBS is characterized by abdominal pain, constipation, bloating, anddiarrhea, while fibromyalgia is characterized by pain throughout the body,along with tender points. IC patients have pain in the bladder. All threeconditions affect women more than men. Stress and anxiety can exacerbatesymptoms of all three, Chelimsky tells WebMD.
For the study, 79 women with IBS, 77 women with fibromyalgia, and 129 womenwith IC filled out a questionnaire asking about the severity of their symptomsthroughout the month.
A total of 25% of the IBS patients, 18% of the fibromyalgia patients, and 9%of the IC patients reported worsening of symptoms during or before theirperiod.
While not addressed by the study, Chelimsky believes fluctuations in hormonelevels may explain the findings.
“Estrogen is a pain preventative,” Chelimsky says. Levels are at theirlowest right before menstruation and are still low while a woman has herperiod.
Additionally, 15% of women in the study reported worse pain at menopause,another time estrogen levels drop. In a surprising finding that the researcherscould not explain, 37% of women said symptoms got worse at the time of theirfirst period.
Also unknown is why symptoms fluctuate with hormone levels in some women andnot others.
The findings of the poster presentation were reported here at the annualmeeting of the American Academy of Neurology.
Asked to comment on the findings, Nathan Wei, MD, clinical director of theArthritis and Osteoporosis Center of Maryland, says, “This study confirms theclinical impression made by practitioners for many years — that hormonalshifts play a major role in symptom exacerbation.”
Chelimsky says that other research shows that women with IBS, fibromyalgia,and IC who are on estrogen-containing birth control pills seem to have fewersymptoms than other women with the conditions.
“I wouldn’t recommend patients go on the pill [for this reason],” Chelimskysays.
“But if they have bad periods, they may want to get on an exercise program.Studies have shown that’s the best thing you can do to improve symptoms,” hesays.