Sexual Dysfunction in Fibromyalgia
Kayhan et al. note that sexual dysfunction is a major public health problem and that it has a greater effect on females. (Sexual dysfunction, mood, anxiety, and personality disorders in female patients with fibromyalgia, Fatih Kayhan 1, Adem Küçük 2, Yılmaz Satan 3, Erdem İlgün 4, Şevket Arslan 5, Faik İlik 6 Neuropsychiatr Dis Treat. 2016 Feb 16;12:349-55. doi: 10.2147/NDT.S99160. eCollection 2016, DOI: 10.2147/NDT.S99160, available in full online at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4762461/.)
Features include: lack of sexual desire, sexual aversion, orgasmic disorder, and dyspareunia.
Kayhan et al. found that sexual dysfunction, mood, and anxiety disorders are frequently observed in female patients with fibromyalgia. They also found that “pain plays a greater role in the development of SD in female patients with FM.”
Anecdotally, woman with fibromyalgia who have vulvodynia tend to avoid intercourse in order to avoid the pain.
Reduction in sexual desire/reduced libido
A literature review by Bazzichi et al. found that fibromyalgia in women is associated with: “a decreased sexual desire and arousal, decreased experience of orgasm, and in some studies an increase in genital pain”. They write that: “The psychological aspects, together with the stress related to the constant presence of chronic widespread pain, fatigue and sleep disturbances, are certainly a major factor that adversely affects the sexuality of the patient with FM. Moreover, the drugs most commonly used in these cases may interfere negatively on the sexuality and sexual function of these patients.” (Fibromyalgia and sexual problems. Bazzichi L1, Giacomelli C, Rossi A, Sernissi F, Scarpellini P, Consensi A, Bombardieri S. Reumatismo. 2012 Sep 28;64(4):261-7.)
A broad literature review by Kalichman found that women with fibromyalgia are more prone to: “decreased sexual desire and arousal, decreased experience of orgasm, and increased pain with intercourse.” Kalichman proposed that the sexual dysfunction, in fibromyalgia may be partly due to depression which can be “responsible for desire and arousal problems.” Kalichman further stated that “the threshold at which sensory input becomes painful is lower than normal that can explain pain on intercourse.” (Association between fibromyalgia and sexual dysfunction in women. Kalichman L1.Clin Rheumatol. 2009 Apr;28(4):365-9.
Use of the Pelvic Floor Distress Inventory 20 (PFDI-20) in fibromyalgia
Urogynecology clinics often see fibromyalgia patients with high “symptom burden from bothersome pelvic pain syndromes”. They were studied by Jones et al. using several questionnaires including the FIQR, “the Pelvic Floor Distress Inventory 20 (PFDI-20), the Pelvic Pain, Urgency and Frequency Questionnaire (PUF), and the Revised Fibromyalgia Impact Questionnaire (FIQR). Results showed that “severity based on FIQR score (57.2 ± 14.9) positively correlated with PFDI-20 total 159.08 ± 55.2 (r = .34, p < .001) and PUF total 16.54 ± 7 (r = .36, p < .001).” (Pelvic Floor and Urinary Distress in Women with Fibromyalgia. Jones KD1, Maxwell C2, Mist SD2, King V3, Denman MA4, Gregory WT4. Pain Manag Nurs. 2015 Aug 7.) Jones et al. noted that pelvic floor disorders were “negatively influence a woman’s activities of daily living, sexual function, bowel and bladder function, and overall quality of life.
This is a fibromyalgia co-morbidity. It can cause dramatic pains and aversion to sex because of the pain.
For further information see the entry on “Vulvodynia/Vulvar Vestibulitis Syndrome/VVS” in the Encyclopedia of Touch, Body Sense and Pain (https://encyclopediaoftouchbodysenseandpain.com/Vulvodynia/Vulvar_Vestibulitis_Syndrome/VVS).