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Fibromyalgia and Pregnancy

I often get asked about pregnancy and fibromyalgia, here are some FAQ on this important topic based on my clinical experience and review of the medical literature.

Does fibromyalgia affect fertility?

Clinically my patients with fibromyalgia seem to have more fertility issues, and I think there are a few reasons for this 1) higher levels of inflammation 2) hormone alterations caused by the chronic fight-or flight response and 3) myofascial restrictions around the uterus and fallopian tubes. All of these factors can have a negative influence on fertility. However one study from Turkey found no difference in pregnancy or birth rates in women with fibromyalgia compared to healthy women. Most of my patients have ultimately conceived even if the road to conception was a bit bumpier or longer.

To optimize fertility in fibromyalgia we need to reverse the three inhibiting factors I mentioned. First reduce inflammation by making dietary changes to avoid triggering foods, or adding a medication like low dose naltrexone. Lowering inflammation can improve hormone balance, as can supporting our adrenals, because any component of adrenal burnout will drag down all the other hormone systems. Learn more about treating adrenal burnout here. Finally myofascial release therapy can break up the myofascial restrictions around the uterus and fallopian tubes.

Does fibromyalgia increase the risk of my baby having birth defects?

The short answer is no it does not. The longer answer is that having fibromyalgia does slightly increase risk of intrauterine growth restriction and smaller birth weight babies. This is likely due to the effects of the overactive fight or flight (stress response) as it is also seen in women with pregnancies experiencing external stressors such as war, poverty and intimate partner violence. But in those cases also see higher rates of preterm or early delivery, and that is not seen in women with fibromyalgia.

Are my fibromyalgia symptoms going to get worse during pregnancy?

Most often the answer is yes. In fact, fatigue, low back and pelvic pain are common in most healthy pregnant women who do not have fibromyalgia. One study found that 26% of healthy pregnant without fibromyalgia had widespread pain and fatigue severe enough to be diagnosed with fibromyalgia!

Another study found that 60% of healthy pregnant women reported fatigue during the last trimester and 75% complained of disturbed sleep. And in a study of 26 women with fibromyalgia who had a total of 40 pregnancies, all except one women described a worsening of their symptoms during pregnancy, with the third trimester being the worst. The good news is that none of these women reported fibromyalgia having a negative outcome on their pregnancy outcome or on the health of the baby. I do have some patients—especially those with both fibromyalgia and an inflammatory/autoimmune illness like rheumatoid arthritis or lupus—that feel much better during pregnancy. Pregnancy does alter immune system functioning in a way that can give a temporary remission for autoimmune illnesses.

How do I manage my fibromyalgia symptoms during pregnancy?

The addition of even more fatigue and pain due to pregnancy can be extremely challenging when added on to what someone with fibromyalgia is already dealing with. It is especially hard because in pregnancy our pain management toolbox shrinks due to medication safety concerns. This is where the vital importance of self-care comes in: saying “no” and protecting your time, pacing your activities and taking good care of your muscles with gentle stretching and movement. Gentle prenatal yoga—whether in classes or videos at home—and myofascial release self-treatment can be a life-saver for lowering back and pelvic pain during pregnancy.


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