Males - My Fibro-mates :-) - ratio, differences etc

Ratio women to men seems to be almost 1:1? (Can’t believe it myself tho…)

Reading 9:1 as ratio again (in a meme in the meme-thread), I had a look how qualified wikipedia’s claims are that it is something like 2:1 or (German wikipedia) 1:1.
The English wikipedia cites a source that is not generally readable (costs 30$), which makes bloodcurdling claims, which I’ll quote first, but the German wikipedia bases that on a well-constructed German Randomized Controlled Trial from 2013 saying at most 2.4% compared with 1.8%, which would mean a ratio of 4:3.
My problem with this is not just that the ratio in the clinic I was at and the support groups near here seems more like 4:1 or 8:1, but that judging from the symptoms, amongst friends, relatives, colleagues and acquaintances I only personally know one male who probably has fibromyalgia, but at least 5 females. I know how males (would) talk. And men are changing. And these are all clichés. Maybe not just clichés.
But I think people are jumping to conclusions. However as I said the Trial seems well-constructed…

The English Wikipedia (Jan 31st 2021) claims it’s 2:1, and bases that on a review from 2014:
The conclusion of the abstract is wonderful :roll_eyes: :roll_of_toilet_paper:
Conclusions and relevance: Fibromyalgia and other “centralized” pain states are much better understood now than ever before. Fibromyalgia may be considered as a discrete diagnosis or as a constellation of symptoms characterized by central nervous system pain amplification with concomitant fatigue, memory problems, and sleep and mood disturbances. Effective treatment for fibromyalgia is now possible. WOW! NO! This is dissented in the following article

Findings In this systematic review, the effectiveness of most therapies for fibromyalgia was not supported. Strong evidence supported only cognitive behavioral therapy for pain, as well as antidepressants and central nervous system depressants for pain and quality of life, but these associations were small.
Conclusions and relevance: This systematic review and meta-analysis suggests that most of the currently available therapies for the management of fibromyalgia are not supported by high-quality evidence. Some therapies may reduce pain and improve QOL in the short to medium term, although the effect size of the associations might not be clinically important to patients.

The PubMed-version Association of Therapies With Reduced Pain and Improved Quality of Life in Patients With Fibromyalgia: A Systematic Review and Meta-analysis - PubMed

The German wikipedia (Jan 31st 2021) first states more women have it than men, but then states that it’s estimated to be roughly the same, that however the ratio of those treated in a clinical context is 4:1. They cite this German-language paper
which as a source cites this seemingly well-constructed Randomized Controlled Trial from 2013 (English-language, PubMed)

“The current study noted that the mean level of WPI and the prevalence of fibromyalgia did not differ significantly by sex, although there was a nonsignificant female predominance (59.6% versus 40.4%) among those with fibromyalgia ( P = 0.372); for women, fibromyalgia prevalence was 2.4%, compared with 1.8% in men. Other population studies have found that rates of widespread pain for the sexes were similar, and that there was only a modest increase of fibromyalgia in women compared with men (25, 27). By contrast, in clinical populations women constitute as many as 90% of patients. Increased rates in clinical populations have been attributed to the use of the tender point count and sex differences in health‐seeking behavior. George Ehrlich noted, however, that “No one has FM until it is diagnosed … it has to be named by a doctor to exist” (28). This observation underscores the difference between the number of people who satisfy criteria for fibromyalgia and the number who actually seek care for symptoms that are cast by physicians or patients as fibromyalgia.”

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Different quality in symptoms etc.

However, the FM patients only showed significant differences in the sensibility threshold to the pain, which was lower in the women. In addition, the best predictor of the experience of pain in males was sleep quality, and in the women, catastrofying pain. (Fibromyalgia in men and women: comparison of the main clinical symptoms, 2012)

Thematic analyses of the survey responses suggest that men with FM have negative experiences with (1) physical and mental health, (2) quality of life, (3) relationships, and (4) careers as a result of FM. Interactions with health-care providers were deterred by (1) potential for misdiagnosis or dismissal of symptoms, (2) stigma of having a condition primarily affecting women, (3) differences in treatment of men and women with FM, and (4) need for health education resources. These findings dictate a need to improve communication between health-care providers and male FM patients. (Understanding the Impact of Fibromyalgia on Men: Findings From a Nationwide Survey Am J Mens Health. 2018)

“there is yet little knowledge about the gendered aspect of pain by men who suffer from typical female diseases like fibromyalgia.
The masculine identity of the participants was re-negotiated by comparisons to other men and life before symptom onset, and by discussing expectations and beliefs of how men should act in contemporary societies. The transition from experiencing a strong, active and reliable body to experiencing a painful, vulnerable and helpless body was perceived as fundamental. Conclusions: Self-management and rehabilitation of fibromyalgia it is not only about learning to manage the symptoms but also about the struggle to find coherence in life through re-constructing gender identity that is acceptable both for the individual and for the community. ( “I can’t have it; I am a man. A young man!” - men, fibromyalgia and masculinity in a Nordic context 2019)




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