One of the readers of this blog, Rachel, left me this question in a comment: Does FMS really go away when pregnant? I will do my best to answer this question and I hope that my answer helps you throughout your pregnancy experience. Congratulations on the journey you will be embarking upon.
Life with fibromyalgia is often times uncomfortable and debilitating. For some women, pregnancy with fibromyalgia can be challenging and overwhelming. My toddler will be two next month and my diagnosis of fibromyalgia did not come until months after I gave birth. That is not say that I was not suffering from FMS symptoms during that pregnancy. In fact, I had fibromyalgia symptoms that went back to the mid-1990s when I was still a teenager. It took me nearly ten years to get a diagnosis and that diagnosis only came after I experienced a major rheumatoid arthritis flare up in 2008 that started less than one week of giving birth in September 2008.
My pregnancy with fibromyalgia was indicative that something was wrong, this to say the least. However, because I had symptoms of both RA and FMS going back nearly ten years, I was more than relieved to say bye-bye to the joint pain that would come and go over the years. I pretended that the nine months of nausea and sensitivity to odors were just morning sickness when, in fact, they were symptoms of a mysterious illness that I had not yet been diagnosed with.
At nine months pregnant, I was still experiencing nausea and vomiting due to sensitivity to odors. If I ate breakfast, I would become sick at the front door as I left my home. I purchased a hand held massager because of the muscle pain I experienced. I always felt as big as a house even though I barely gained any weight during my pregnancy. I never had any appetite and I never ate like a pregnant woman. Everything made me sick and I was weak all the time. But I did not have joint pain, and I dismissed the remainder of my symptoms to being pregnant. I told myself that these symptoms were a normal part of pregnancy and while extreme, they were “normal.”
My pregnancy was not comfortable and by the time my nine month came around, I begged my doctor to induce me. I was in tears at every appointment because I hated being pregnant and because I did not know why I was so sick, I could not really communicate to my doctor that my pregnancy was not “normal.” Eventually, my doctor gave in and scheduled me to be induced and I was in labor for three days. My pregnancy and my labor were tiring and if I had known why, I would have known how to best take care of myself and minimize my fibromyalgia symptoms. But I didn’t and I chalked up my symptoms to be pregnant.
Pregnant With Fibromyalgia
For many years, I had symptoms of both RA and FMS, but without a diagnosis, I believed that there was nothing wrong with me because I was told that there wasn’t. When I hit my second trimester while pregnant with my now toddler, I had no RA symptoms so I assumed that whatever was wrong with me was gone. I also assumed that my other symptoms, in particular the nausea and the sensitivity to odors, were part of being pregnant. The muscle aches and pains were also, in my mind, part of being pregnant. I had not yet heard of fibromyalgia or even rheumatoid arthritis and because I had always experienced severe morning sickness throughout my other pregnancies, I did not feel that there was anything usual about my pregnancy.
With over 5 to 6 million people diagnosed fibromyalgia and most of those women, the incidences of women with fibromyalgia that are pregnant are quite high. Many of those women, similar to my experience, are undiagnosed. There is some research out there that indicates that pregnant women with FMS may experience a reduction of symptoms. According to Brian A. Mason, MD, FACOG, an Associate Professor at the Division of Perinatology at Wayne State University in Detroit, Michigan, and a perinatologist (high risk obstetrician) at the Division of Maternal-Fetal Medicine at St. John Hospital and Medical Center in Detroit, Michigan, “In pregnancy there is an increase in serotonin and cortisol, which is the body’s form of cortisone. This inhibits the body’s autoimmune response and perception of pain. We often see women with chronic pain and autoimmune disorders improve during pregnancy.” This may be true for some lucky patients, but some others describe as “a never ending state of premenstrual syndrome.”
Many women who suffer from fibromyalgia fear getting pregnant because they fear worsening of symptoms. While pregnancy does bring with more pain and fatigue for a FMS sufferer, there is no reason to believe that a woman with FMS cannot deliver a healthy baby. In fact, many women who were diagnosed after having children can attest to the truth in that.
Obstetricians and rheumatologists supervise pregnant women with fibromyalgia to make sure that patients are eating and sleeping well. Stress reduction is also encouraged, in addition to the use of magnesium to relieve symptoms of fibromyalgia during pregnancy. There is not a lot of research out there as what the effects of fibromyalgia are on pregnancy so doctors treat symptoms without fully understanding them. The best way to control symptoms of FMS during pregnancy is through diet because antidepressants and other FMS medications are not safe during pregnancy. Likewise, expectant mothers should not use sleep aid medications or anti-anxiety medications during a normal pregnancy so a FMS patient should even more cautious.
Mothers should who plan breastfeeding should understand that FMS medications should not cross with breast milk before and after delivery. Moreover, breastfeeding can be difficult because of chronic muscle pain in fibromyalgia. (Chronic muscle pain in my breasts made breastfeeding very painful so I choose not to breastfeed.) Most women whose symptoms dissipated during pregnancy have a major return of symptoms after delivery. Because of that, it is important to be as stress free as possible if you want to continue breastfeeding.
There is always a way
While all this information seems daunting, good medical care with a qualified and knowledgeable obstetrician can help a pregnant FMS patient experience relief from symptoms, have a healthy pregnancy and a manageable labor and delivery. Moreover, it is always best to make sure that you have a support system after you deliver because of the chance of returning symptoms and some mild to moderate symptoms of depression.
I encourage women who want to be mothers to not be afraid of autoimmune diseases or fibromyalgia with pregnancy. Educate yourself and work with your doctors if you want to have children and do not let your conditions discourage you. Women with fibromyalgia are strong and they learn (the hard way) how to prioritize and what is most important in their lives. If having a child is very important to you, take care of yourself, surround yourself with love and support, and start your journey towards motherhood.
Back to Rachel’s question: Do FMS really go away when you are pregnant? In some cases, there is a reduction in symptoms. In addition, proper medical care, changes in diet, stress reduction and support will help to further additional reductions in symptoms. For more information on pregnancy and fibromyalgia, visit the fibromyalgia and pregnancy page at National Fibromyalgia Association’s website.
* * *
If you like have a question related to rheumatoid arthritis or fibromyalgia that you would like me to answer, please feel free to either leave it in a comment box anytime (leave your email/website link so I can notify you when it is answered) or send me an email to firstname.lastname@example.org. I will do my best to answer your question.