Fibromyalgia is a complex chronic pain disorder characterized by widespread muscle pain, fatigue, sleep problems, and often depression. There are no lab tests to confirm a fibromyalgia diagnosis, so it is usually made based on a person's symptoms.
While the exact causes are still unknown, research suggests fibromyalgia may be related to changes in how the brain processes pain signals and abnormalities in the endocrine system. Some studies have found people with fibromyalgia tend to have relatively low levels of certain hormones like cortisol, growth hormone, thyroid hormones, and sex hormones like estrogen and testosterone.
This has led some practitioners to believe that hormone replacement therapy (HRT) may help relieve fibromyalgia symptoms in some patients by:
- Regulating hormone levels
- Reducing inflammation
- Improving sleep quality
- Increasing energy levels
- Lifting mood
However, the research is still limited and mixed on whether HRT helps with fibromyalgia. Some key points:
Studies Specifically on HRT for Fibromyalgia
- A 2017 review study found some limited evidence that HRT, especially DHEA (dehydroepiandrosterone), may improve pain and well-being in postmenopausal women with fibromyalgia. However, it concluded larger, longer studies are still needed.
- A 2020 study evaluated transdermal testosterone replacement in women with fibromyalgia. After 3 months of treatment, the women had significant improvements in pain, fatigue, sleep quality, and overall fibromyalgia impact.
- Another 2020 case review described 4 perimenopausal and postmenopausal women who experienced substantial reductions in fibromyalgia symptoms with compounded bioidentical HRT containing BiEst (estrogen/progesterone combo), testosterone, DHEA, and cortisol.
So while a few recent studies show promising results, more research is still needed specifically looking at HRT for fibromyalgia relief.
Factors to Consider
While HRT may potentially help
some patients, experts warn it does not help everyone and comes with risks if not closely monitored. Important factors to consider:
- There is no single formula that helps all patients - hormone levels and needs can vary greatly between individuals. Customized HRT is usually more beneficial.
- Patients with hormone deficiencies or imbalances may respond better than those with normal labs. Testing levels first is wise.
- The patient's age, symptoms, medical history, genetics, lifestyle and more can impact treatment success. A specialized practitioner is key.
- Like any therapy, close follow up and adjustment of hormone dosing and delivery methods is crucial to balance benefits and risks.
Potential Benefits
When properly administered and monitored, some potential benefits reported by patients using HRT for fibromyalgia include:
- Decreased widespread muscle pain and tender points
- Reduced fatigue and improved endurance energy levels
- Better sleep quality and duration
- Improved mood - less depression/anxiety/irritability
- Increased mental clarity and concentration
- More regulated temperature control and sweating
- Reduced other symptoms like headaches, IBS, TMJ pain
Risks & Considerations
HRT does come with some risks like blood clots, stroke, cardiac issues for those predisposed. Patients should carefully consider pros vs cons with their healthcare provider. Those with risk factors like smoking,
obesity, thrombosis history could have contraindications. Key precautions include:
- Adjusting doses slowly and carefully
- Monitoring for reactions and side effects
- Following up regularly with bloodwork and health assessments
- Using the lowest effective dose
- Combining with lifestyle approaches like improved diet, stress reduction, appropriate exercise
In Conclusion
Some patients may find substantial fibromyalgia relief from customized, closely monitored hormone replacement therapy. However, response varies greatly between individuals. More research is still needed to clarify effectiveness and safety.
Women struggling with fibromyalgia and hormonal issues should discuss options like HRT, bioidentical hormones, testosterone therapy or DHEA with an experienced, specialized practitioner.
Our physicians develop fully individualized hormone therapy programs to help patients optimize wellbeing while carefully considering risks and benefits.
