Why fibromyalgia and depression are prevalent in women

A study in Sweden may hold the answer Photo: wikipics public domain

WASHINGTON- December 16, 2013 — Research from Sweden has shed light on why women are more likely suffer from depression, chronic pain syndrome (CPS) and fibromyalgia syndrome (FMS) than men. This same study has uncovered mechanisms on why women are prone to depression and mood swings from pre-menstrual syndrome (PMS) and post-partum depression.

Using positron emission tomography scans (PET) that creates a three-dimensional image of the brain and other areas, Karolinska University in Sweden has determined the neurotransmitter ‘serotonin’ and receptor sites in women are clearly different from men.

SEE RELATED: Fibromyalgia study blames processing abnormalities for pain

Serotonin production, re-absorption and normal levels in many women are not sufficient and wreak havoc on the mind and bodies of those affected. The effect on female hormones is broadly significant.

Serotonin, known as the ‘happy hormone,’ plays a significant role in pain management.

Every cell has what is known as receptor sites that allow substances such as nutrients and hormones in and out for nourishment and proper functioning. There must be adequate serotonin receptor sites in the brain to maintain a healthy level of contentment. The good news is women have more receptor sites than men so logic would seem to dictate women should be happier.

The study also shows that women have lesser levels of protein that sweeps away serotonin that has already circulated keeping serotonin levels higher as new serotonin is secreted.

SEE RELATED: New studies find causes of fibromyalgia, offer hope of relief

The bad news is having more receptor sites is not necessarily a good thing for hormonal stability.

Cells requiring serotonin activate more receptor sites to assure availability. Since lower levels of discharge protein causes retention by the millions of cells needing serotonin, they get greedy and hold onto what they have thus depriving other cells of hormonal nourishment.

The study suggests that, as a result, there is not enough serotonin secreted. This leaves women with far fewer levels of this vital hormone to maintain good mood and happiness and can elevate symptoms of PMS.

Additionally, decreased levels of serotonin lead to greater levels of pain sensitivity. This phenomenon means that compared to men, women live with unhealthy levels of serotonin and suffer the consequences.

SEE RELATED: Fibromyalgia solved: Not in the mind, but a very real physical ailment

A supporting study from the University of Montreal posit males produce 52 percent more serotonin than women and ties this research to claims by the British Society for Neuroendocrinology of estrogen levels.

Estrogen “stimulates serotonin receptors in the brain” explains Dr. Andrei Novac of the University of California, Irvine School of Medicine. When estrogen levels fluctuate in the brain, the brains sensitivity to serotonin alters, leaving the amount of the hormone in short supply. Apparently, when estrogen levels are low, serotonin levels are significantly reduced and this is a known occurrence prior to menstruation, menopause and during the child birthing experience.

This effect is cumulative, creating higher levels of persistent stress and anxiety, poor mood control and eventually, possibly depression. Additionally, stable levels of hormones play a remarkable role in the puzzle of fibromyalgia.

Chronic or clinical depression can be causation of chronic pain. Chronic pain can lead to chronic or clinical depression, so healthy levels of serotonin play a significant role in managing depression and chronic pain.

Those with fibromyalgia may suffer depression from chronic pain so a healthy level of serotonin is essential to manage fibromyalgia. Medications such as serotonin and norepinephrine reuptake inhibitors SNRI) such as Savella, Prozac and Cymbalta are widely known to manage hormone levels and treat chronic central nervous system (CNS) pain disorders. Other medications such as Neurontin are beneficial for peripheral pain.

The two together can be a one-two-three punch to solve the lack of serotonin, help resolve CNS  and peripheral pain and if one medication delivers poor results or unacceptable side effects, trying others can yield desired results.

For fibromyalgia specifically, research now indicates the better choice for pain are the older tricyclic antidepressants (TRA) that have been shown to be more effective according to Dr. Rajesh Karla, medical director of Chronic Pain Management at Kaiser Permanente, Union City, CA.

As with SNRI’s, one TCA is not the same as the next so sometimes, experimenting is key to treatment. TCA’s are; amitriptyline, amoxapine, desipramine,, doxepin, imipramine, nortriptyline, protriptyline and trimipramine.

TCA’s are older, time- tested drugs with substantially documented histories.

No information in this article is designed to replace or substitute doctor’s advice. Always consult a physician and/or professional mental health practitioner for guidance.


Paul Mountjoy is a Virginia based writer and psychotherapist



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