One of the prevailing hypotheses on the pathogenesis of fibromyalgia (FM) emphasizes the role of the hypothalamic-pituitary-gonadal axis in this condition. Aberrant function of the axis was inferred from decreased concentrations of growth hormone and serotonin and reduced urinary excretion of corticosteroid metabolites observed in FM patients. Studies in a very limited number of FM patients suggest that disturbances in the hypothalamic-pituitary-gonadal axis may also lead to changes in the synthesis of sex hormones.
This study was performed in 19 women aged 23 to 46 years in whom FM was diagnosed according to ACR criteria. The control group consisted of 18 healthy women aged 21 to 41 years. Pain intensity and sleep quality was assessed with the Visual Analogue Scale (VAS). The number of points reported as painful ("tender points") was measured by dolorimetry. Hormones or contraceptives were not administered to the women during the pre-study period. Blood was collected on day 8 or 9 of the menstrual cycle and serum was prepared for measurements of estradiol and progesterone with Microparticle Enzyme Immunoassay (MEIA) and AxSYM reagents from Abbott (USA).
The study and control groups differed as to pain intensity and sleep quality, as well as number of tender points reported. However, groups did not differ as to mean concentration of estradiol or progesterone.
A deficit of sex hormones does not appear to be part of the manifestations of FM.