Regarding the pain of men: characteristics of fibromyalgia in male patients.

OBJECTIVES: Fibromyalgia (FM) is a chronic pain disorder with a female predominance. The impact of gender on the epidemiologic and clinical characteristics, as well as therapeutic strategies for FM patients, remains incompletely understood. This study aims to outline the clinical and epidemiologic profiles of male FM patients in comparison to female patients.

METHODS: A retrospective cross-sectional observational study was conducted, encompassing all patients diagnosed with FM in the electronic medical record database of a tertiary hospital from 2010-2021. Each patient file was individually reviewed, and data was collected.

RESULTS: A total of 3044 patients were diagnosed with FM, of which 401 were male (13.2%). A random cohort of 438 female patients was created for comparison with the male cohort. The average age of male patients at the time of their FM diagnosis was notably higher than that of females (52.7 years vs. 44.9 years, p<0.001). Obesity was more prevalent among female patients (16% vs. 9.2% for males, p=0.003), while obstructive sleep apnoea was more common in males (6.7% vs. 1.8%, p<0.001). Male patients exhibited a significantly higher prevalence of post-traumatic stress disorder (PTSD) than females (14% vs. 5.7%, p<0.001). Among male patients, 48% were treated with medical cannabis compared to 34.6% of females (p<0.001).

CONCLUSIONS: Distinct clinical gender-specific characteristics were identified in our real-world cohort of FM patients. PTSD and the use of medical cannabis were more prevalent among male patients, whereas obesity was more common in females. Further studies exploring the clinical and pathogenic mechanisms underlying these differences are recommended.