Increased fatigue and joint aches are common symptoms of menopause. So when are these symptoms considered “normal” or fibromyalgia or chronic fatigue syndrome (CFS)?

One important factor to consider is the duration fo symptoms. Six months or greater warrants an evaluation with your clinician. The majority of people with fibromyalgia and CFS have a normal lab evaluation. For this reason having a good history and physical exam performed by your clinician really matters. It can be very helpful to keep a short journal of symptoms as well to bring to your appointment. If fatigue is greatly increased after physical exercise/stress, CFS or fibromyalgia are possible diagnoses. 

1. CFS is not well understood. Features include severe fatigue not lessened with rest, poor sleep, lightheadedness with standing and brain fog.  
2. People with fibromyalgia have increased pain out of proportion to input.
3. Causes of fibromyalgia and CFS are unknown. There is an association in some cases with postviral syndrome. 
4. The symptoms of fibromyalgia and CFS overlap but there are some additional differences. For example,CFS usually occurs in ages teens to 30’s while fibromyalgia occurs between ages of 20’s-50. 
5. The American College of Rheumatology has criteria to make the diagnosis of fibromyalgia involving symptoms of pain, fatigue, cognitive symptoms and sleep. The pain can come and go in different locations. Onset of fibromyalgia is gradual. These individuals often have other symptoms such as IBS, TMJ, chemical sensitivities, bladder pain, and more severe hot flashes.
6. People with CFS tend to have sudden onset of symptoms after an event. While pain is common with CFS, the main symptoms is post-exertion fatigue. 
7. Some women develop fibromyalgia with menopause while others have a worsening of their fibromyalgia symptoms with menopause. Hormone therapy and an exercise regimen can be very helpful for these patients. There are several FDA approved medications for fibromyalgia. 

Please do not ignore your symptoms.

---