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Ask 10 people about their image of the typical fibromyalgia patient, and it’s likely that all 10 will describe a typical fibro sufferer as being a woman. While it’s true that 80 to 90 percent of fibromyalgia patients are women, new evidence suggests that the illness may be widely underdiagnosed in men. One study suggests that fibromyalgia is underdiagnosed in both men and women—and the actual rate in men may be as much as 20 times higher than currently diagnosed. Here are some possible reasons men may be underdiagnosed.
Bias Against Seeking Health Care
It’s not just a stereotype that men avoid going to the doctor. According to the Centers for Disease Control, men are 80 percent less likely than women to go to the doctor. One-third of men haven’t had a check-up in the past year. Half of all men don’t even have a regular doctor. Even if they do see a doctor, men are less likely than women to mention physical complaints like fatigue and muscle pain. Men are culturally taught to “buck up” and accept such pains as normal.
Men who do not have a regular relationship with a doctor are less likely to seek a diagnosis for fibromyalgia symptoms in the first place. But for those who do seek care, their lack of an ongoing relationship with a doctor may make it less likely for them to be correctly diagnosed.
Poor Diagnostic Methods
Fibromyalgia is usually diagnosed based on an 18-point checklist developed in 1990 by the American College of Rheumatologists. The checklist is based on tenderness or pain at certain pressure points throughout the body. The document has only been updated twice since 1990, and many fibro advocates believe the diagnostic criteria is outdated and insufficient.
Medical Bias Against Diagnosing Men
The myth that fibro patients are always women may be so deeply ingrained in society that a male patient’s description of symptoms like headaches, sleep problems and body pain don’t suggest fibromyalgia to medical staff. Doctors may be more likely to diagnose men with an illness that has similar symptoms to fibromyalgia, such as rheumatoid arthritis, lupus or even sleep apnea.
Men May Have Different Symptoms
A 2012 study suggests that men with fibromyalgia may experience different symptoms than women with the same illness. According to the study, men have a higher pressure pain threshold at the 18 pressure points than women and experience less pain overall. However, men with fibromyalgia are also more likely than women to have intense, ongoing pain in the neck region. Other research suggests that even though depression is a common fibromyalgia symptom for women, men may be even more likely to be depressed than women. Although men may have fewer intense physical symptoms than women, they tend to be more socially and mentally impacted by the effects of their illness.
Any sort of chronic illness tends to be more difficult to diagnose in men, in large part because men are more likely to downplay their symptoms as nothing serious. When they do seek a diagnosis, doctors are prone to look for different causes. It’s time for the medical community to learn that fibromyalgia can impact anyone, even men.
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