Understanding The Link Between Fibromyalgia And Perimenopause

Last updated 01.29.2024 | by Sabrina Johnson | 10 Minutes Read

This article has been reviewed and fact checked by Dr. Karen Pike, a senior physician administrator and board-certified emergency room doctor actively working in northern California. Read more at our medical disclaimer page.

Did you ever hear of someone diagnosed with fibromyalgia? If you are wondering if it is something big and complex, to your knowledge, let me tell you that fibromyalgia is a painful condition characterized by fatigue, tenderness, aches, and pain not just in the muscles but even in the soft tissues throughout the body. Fibromyalgia is more common in women and is barely diagnosed in men. If I were to go by the data, around 80-96% of women experience this condition. A doctor, while discussing this condition, said that females are twice more likely to experience fibromyalgia than their male counterparts. The fluctuating estrogen and progesterone levels are responsible for fibromyalgia.

Coming to the topic, what’s the connection between perimenopause and fibromyalgia? You may be acquainted with the term perimenopause. Yet, I would like to brush it up with you. The term perimenopause refers to the phase when your body is preparing to transition into menopause. The age for perimenopause varies but is usually seen in women who are 40-44 years old. Your body goes through umpteen changes then, and some of them overlap with the fibromyalgia symptoms. You may be near menopause, but the aches and pains could be misdiagnosed as fibromyalgia or vice-versa.

I met a lady at the doctor’s office who was close to 50. She explained that she was diagnosed with fibromyalgia in her 30s. She would have her regular bouts of fatigue. Of late, her exhaustion kept worsening to the point that she would often head back to bed straight after breakfast.

Moreover, those messy headaches were awful. She didn’t want to make any assumptions about her condition. So, she followed up with the GP immediately and was sent for a blood test; the doctor said that the heightened fatigue was not because of her fibromyalgia but because she was nearing menopause. She said, “I know this was something I should have considered, but this thought never crossed my mind..”

Are you in your 40s? Do you find yourself troubled immensely with fatigue, headache, muscle aches, and pains of late? You could be wondering if it has something to do with your muscle health or indicates any other problem. I would suggest you read this article, where I have included the link between fibromyalgia, perimenopause, and menopause. I have also elaborated on the symptoms of fibromyalgia and mentioned the management techniques.

Understanding the Connection Between Perimenopause, Menopause, and Fibromyalgia

I already gave you a glimpse of the relationship between fibromyalgia and perimenopause. Let’s get into a detailed explanation.

Hormonal fluctuations are an integral part of a woman’s life. You will go through it during puberty, pregnancy, before your menses, and also during the phase when you are transitioning into menopause. The hormonal fluctuations, particularly the spike and drop in estrogen levels, are responsible for an increased prevalence of fibromyalgia in females.

When the estrogen levels are steady, it helps to reduce your pain sensitivity. Whereas when your estrogen levels drop, it increases your susceptibility to pain. Now, if you have had fibromyalgia before the menopausal age, chances are that the fluctuating hormone levels could worsen your condition. Another possibility could be that the hormonal imbalances have triggered chronic pain – something that you didn’t face before.

I was going through the findings of a recently conducted study that mentioned that menopausal women were twice as likely to get diagnosed with chronic pain for multiple conditions like migraine, back pain, and fibromyalgia. There isn’t any concrete evidence to suggest how fibromyalgia is related to perimenopause and menopause. However, the facts deduced through studies highlight that symptoms of FM intensify at the onset of menopause. It was also shown that women with fibromyalgia, in the peri and postmenopausal phases, were relatively high in vasomotor symptoms (hot flashes and night sweats).

The main catch lies in the fact that the symptoms of perimenopause and fibromyalgia overlap. It gets difficult to understand what’s going on with your body. If you have always been bothered by aches and pains and have experienced a sudden rise after a certain age, possibly your 40s, it is time to get yourself checked. Fibromyalgia may not always be the reason. You might also be transitioning into menopause. In the section that follows, I will walk you through some of the symptoms of fibromyalgia, which will help you understand how similar it is to the ones that you may experience in perimenopause and menopause.

Symptoms of Fibromyalgia

Symptoms of Fibromyalgia

Here are some of the main symptoms many women affected by fibromyalgia will experience. You will be amazed to know that some of the perimenopausal signs are also symptoms of fibromyalgia. Let’s take a look:

  • Joint and muscle pain that is widespread, experienced on each side of the body, both above and below the waist
  • Fatigue
  • Sleep issues, wherein people have complained of waking up tired, even after having slept for long hours; some have even mentioned disrupted sleep due to pain; fibromyalgia patients may experience other sleep problems like sleep apnea and RLS (Restless leg syndrome).
  • Cognitive issues, called fibro fog, make concentrating and paying attention difficult.
  • Low mood and anxiety

A Detailed Explanation of How Fibromyalgia and Menopause Symptoms Can Be Very Similar

More than 50% of women go through joint pain in menopause. A study conducted on around 100,000 middle-aged women showed that menopause increased their susceptibility to chronic pain by around 85%.

Fatigue is one of the most common menopausal symptoms. A cross-sectional study conducted on about 3000 women showed that around 85.3% of postmenopausal had physical and mental fatigue.

Sleep issues are common in 40-60% of perimenopausal and menopausal women.

Around 2/3rd of the female population go through cognitive impairment during menopause.

Findings show that 18% and 38% of women go through depression in early and late perimenopause, respectively.

The data mentioned above makes it quite clear that fibromyalgia symptoms can be very similar to the symptoms of menopause.

Sometimes, fibromyalgia may not be a condition of its own but may coexist alongside other conditions, like

  • Irritable bowel syndrome
  • Migraine (or other headaches)
  • Interstitial cystitis
  • TMD (Temporomandibular disorders)
  • CFS (Chronic fatigue syndrome)
  • Depression
  • Anxiety
  • PoTS (Postural tachycardia syndrome)

Diagnosis of Fibromyalgia

There isn’t any blood test for women with fibro. The doctor will ask you about the nature of your pain. Is it widespread or confined to specific body sections like your knees and wrists? If the pain spreads throughout your body, then fibromyalgia could be the cause. When a friend experienced severe body aches, fatigue, and mood swings, the doctor advised a thyroid test since some signs of hypothyroidism mimic fibromyalgia.

Similarly, Vitamin B-12 and folic acid deficiencies can also lead to fibromyalgia-like symptoms. So, to rule out the possibility of the same, your doctor may also ask you to do a thorough bloodwork. Moreover, you will even be asked the duration of the pain. Suppose you are in your mid-40s, the average age to reach menopause. In that case, the doctor will enquire about the regularity of your periods and what other symptoms you are experiencing.

Your doctor will plan for a line of treatment based on the information you provide. Some healthcare providers advise the FSH (Follicle follicle-stimulating hormone) to get tested. When they are elevated for quite some time, it may mean that you have transitioned into the late perimenopause phase.

Ways to Treat and Manage Fibromyalgia Symptoms In Menopausal Women

Ways to Treat and Manage Fibromyalgia Symptoms In Menopausal Women

Fibromyalgia and menopause are a challenging aspect indeed, and managing them together is a mammoth task. When devising a fibro management plan, you will observe that it is highly similar to the dos and don’ts advised in menopause. Following a healthy diet as much as possible and keeping yourself physically fit are the prerequisites. Living with fibromyalgia won’t be that difficult when you know the proper ways to manage it.

1. Medicinal Treatment

One of the most common forms of treatment to manage acute pain is pain-relieving medications. Many doctors prefer prescribing anti-depressants to treat fibromyalgia. They help improve your emotional health and your sleep, too. The medicines mainly used include amitriptyline, citalopram, duloxetine, paroxetine, sertraline, and fluoxetine. You should always have them with a doctor’s consultation as they are used to treat long-term pain.

2. Exercise

When you are in acute pain, exercising may seem challenging. However, if you remain physically active, it will eventually help better most of the fibro symptoms. You may not notice the transformation instantly, but the changes may take about six months to effect. You may opt for something as simple as walking yoga or add strength-training exercises to your regime. Pilates, which involves exercising using some special apparatus, is suitable for fibromyalgia patients as it helps improve muscle strength and flexibility. I never had fibromyalgia, but the routine aches and pains bothered me quite often, especially in my mid-40s. Physical exercises came to relief. Exercise isn’t just good for fibromyalgia, but it also helps alleviate specific menopause symptoms like hot flashes, sleep issues, mood swings, etc.

3. Talking Therapy

If you wish to know what type of talking therapy will help in improving fibromyalgia symptoms – well, let me elaborate. It can be of two kinds – ACT (acceptance and commitment therapy) and CBT (cognitive behavioural therapy). ACT helps one to accept things out of one’s control and work towards making changes for a better lifestyle. CBT enables you to change your thought processes and behaviour. It helps fibro patients to ease depression and anxiety.


Does hormone replacement therapy help to distinguish menopause and fibromyalgia?

Hormone therapy, or HRT, is effective in managing several menopausal symptoms. If you have conflicting symptoms of fibromyalgia and menopause, then your doctor might consider putting you on hormone therapy to see if your condition gets any better.
If it does, which may happen anywhere between three and six months, it can be deduced that you are transitioning into menopause, resulting in the changes. Irrespective of whether you are in menopause or the symptoms are due to fibromyalgia, hormone therapy will help to address both conditions. However, do not go for it without a doctor’s advice.

How does diet help to improve fibromyalgia?

Whether it be menopause or fibromyalgia, diet plays a pivotal role in managing most of the symptoms significantly. Following a diet of vegetables and fruits, whole grains, and nuts contributes to maintaining your overall health. You must avoid sugary and fatty foods and identify the triggers which worsen your symptoms.


When you have a renewed focus on sticking to a healthy lifestyle, you will be able to manage most of your symptoms due to menopause, fibromyalgia, or both with ease. Sometimes, it is difficult to understand what is causing the pain and fatigue because women may have no other menopausal symptoms other than this. That is why being aware of your body is essential. Do not feel afraid or shy to talk about your body changes. The more you talk, the better it will help solve your issues immediately.


  • Sabrina Johnson

    Meet Sabrina Johnson, a compassionate author and a seasoned expert in Obstetrics and Gynecology. She is a driving force behind Simply Menopause, where her extensive medical knowledge and empathetic nature come together to empower women in their menopausal journey. Sabrina offers culturally sensitive guidance and support through her approachable writing, making her a trusted friend on the path to menopause wellness.