Fibromyalgia Screening in Patients With Unexplained Chronic Fatigue

Christopher A. Aakre, MD, MSc


Menopause. 2021;28(1):93-95. 

In This Article

Management of Fibromyalgia in Postmenopausal Women

Women with fibromyalgia may experience more bothersome VMS, and therefore HT use may be indicated to reduce VMS burden and improve sleep quality. Graded exercise has the strongest evidence for managing fibromyalgia-associated pain, with weaker evidence for fatigue mitigation.[10] Cognitive-behavior therapy, mindfulness-based therapy, and multicomponent therapies also have weak evidence for pain reduction but may reduce the sensory hypervigilance that contributes to VMS burden in menopause. Some nonhormone treatments for VMS, such as gabapentinoids and serotonin-norepinephrine reuptake inhibitors, also reduce pain in fibromyalgia and may be reasonable alternatives or supplements to HT for their pain-relieving effects.[2] Current FDA-approved medications for fibromyalgia are limited to duloxetine, pregabalin, and milnacipran; other medications with similar mechanisms of action are frequently used off-label.