If DHEA and Androgens Help Then Why is Fibromyalgia(FM) Higher in Polycystic Ovaries(PCO)

DHEA and androgen levels are higher in PCO yet FM rates are 32.5% in PCO versus 7.7 in the general population.

The Frequency of Fibromyalgia Syndrome in Patients with Polycystic Ovary Syndrome.
Journal of Musculoskeletal Pain June 2010, Vol. 18, No. 2 , Pages 120-126
Feray Soyupek, MD Sedat Yildiz, MD Selami Akkus, MD Mehmet Guney, MD Muhittin Tamer Mungan, MD Sevilay Eris, MD  abstract here

  • 40 cases PCO; 39 controls
  • FM rates 32.5% in PCO versus only 7.7% in controls

Hromonal Differences:

  • To be fair, those with PCO and FM had lower androgen levels than those with PCO and NO FM – so androgens might have been some protective.
  • High DHEA and low estrogen levels stand out in PCO plus FM group – suggesting high DHEA could be too much of a good thing…
  • Much higher diffues pain, sleep disturbance, headaches, and fatigue were found in PCO plus FM versus PCO by self – as one would expect.

Addendum: Recent article on PCO finds it is a high cytokine disease:
The role of cytokines in polycystic ovarian syndrome
Krystle Ebejer, Jean Calleja-Agius
Gynecol Endocrinol, 2013; 29(6): 536–540
http://www.ncbi.nlm.nih.gov/pubmed/23368758

  • Pro-inflammatory cytokines especially IL-18  are significantly higher in women with PCOS. Anti-inflammatory lipokine, adiponectin, is significantly reduced in PCO.

Contends that PCO is a cytokine disease fueled by:

    • an altered immune response to microbial and inflammatory stimuli
     

     

     

    obesity (60-70%)  (though non-obese PCO cases still elevated IL-18 cytokines) – “significant increase in hs-CRP, IL-6 and TNF-a is mostly attributed to obesity”

  •  insulin resistance (50% -70%) – Higher levels IL-6 which is produced by adipose tissue and stimulates CRP production by the liver
  • hypothalamic-pituitary ovarian dysfunction and anovulation – progestereone is an immune regulator; no ovulation –  no progesterone
  • High testosterone – Contends that hyperandrogenism increases mononuclear cell senstivity to glucose and hence causes glucose-induced inflammation which in turn leads to increased androgen production by ovarian theca cells – leading to viscous cycle. – most is pure science conjecture rather than relating inflammation to testosterone levels.

Comment -I am not buying idea high testosterone fuels cytokine inflammation.  I still feel DHEA supplementation in FM could help mood if levels are low, and androgen supplementation could help pains, if levels are low. There can, however, be too much of a good thing, and this might suggest such.

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