Fibromyalgia Symptoms in Men and Women, Symptoms Checklist, and Tender Points identified

Fibromyalgia symptoms checklist, tender pointsFibromyalgia symptoms can vary greatly and overlap with many other health conditions, which can make it much more difficult to diagnose fibromyalgia – especially because the underlying mechanisms still aren’t fully understood.

Unfortunately, there isn’t a specific test for fibromyalgia, and that is why it’s so important to fully understand the symptoms in order to distinguish a fibromyalgia diagnosis from other ailments.


Fibromyalgia diagnosis also relies on tender points – these are areas of the body where additional pain is felt when pressure is applied. There are 18 tender points that are tested, and previous testing relied on 11 tender points to show positive in order to make a diagnosis of fibromyalgia. Unfortunately, this isn’t very reliable as tender points can come and go in fibromyalgia patients, so one day they may experience 11 and other days it may only be five.

Although tender points may still be used in the diagnosis of fibromyalgia, there is now more widespread testing, which is used to get a better diagnosis.

Fibromyalgia symptoms in men

Although fibromyalgia is far more common in women than men, men can still experience fibromyalgia, and they may have differing symptoms compared to women. Primary symptoms of fibromyalgia in men are chronic pain and an increase in pain sensitivity.

In men, lower pain intensity, lower tendon-point count, lower depression rates, and longer duration of symptoms are generally reported, along with overall disability due to symptoms.

The differences in symptoms may be attributed to differences in hormones, as fibromyalgia flare-ups in women are often linked to their menstrual cycles. Unfortunately, there is insufficient information on the role of hormones in fibromyalgia, so it is still unclear how exactly male and female hormones may cause differences in fibromyalgia symptoms.

Fibromyalgia symptoms in women

Once again, the primary symptom of fibromyalgia is pain. Other fibromyalgia symptoms in women include:

  • Pain – some pressure points include back of the head, between the shoulders, front of the neck, top of the chest, outside of the elbows, top and sides of hips, and inside of the knees.
  • Fatigue – fibromyalgia causes sleep difficulties, thus contributing to chronic fatigue.
  • Fibromyalgia brain fog – lack of concentration, inability to find the right words or phrases, forgetfulness, etc.
  • Headaches.
  • Painful menstrual cycles.
  • Irritable bowel and bladder.
  • Restless legs, especially while sleeping.
  • Sensitivity to changes in temperatures, bright lights, sounds, etc.

Common symptoms in women

Symptoms can affect different areas of the body. Here is the complete extensive list of symptoms that can be experienced in fibromyalgia.

Fibromyalgia general symptoms

  • Delayed reactions to physical exertion or stressful events
  • Family history of fibromyalgia
  • Sweats
  • Unexplained weight loss or gain
  • Craving carbohydrates and chocolate
  • Headaches and migraines
  • Changes in vision

Muscle and tissue symptoms in fibromyalgia

  • Pain that ranges from mild to severe
  • Morning stiffness
  • Muscle twitches
  • Diffuse swelling
  • Fibrocystic breasts

Fibromyalgia sinus and allergy symptoms

  • Allergies
  • Post nasal drip
  • Runny nose
  • Shortness of breath
  • Mold and yeast sensitivity
  • Earache and itchy ear
  • Ringing ears
  • Thick secretions

Sleep-related symptoms in fibromyalgia

  • Light or broken sleep patterns
  • Fatigue
  • Twitching muscles at night
  • Teeth grinding

Reproductive symptoms in fibromyalgia

  • Menstrual problems
  • PMS
  • Loss of libido
  • Impotence

Fibromyalgia abdominal and digestive symptoms

Fibromyalgia cognitive and neurological symptoms

  • Language impairments
  • Directional disorientation
  • Poor balance and coordination
  • Loss of ability to distinguish shades
  • Short-term memory impairment
  • Confusion
  • Trouble concentrating
  • Staring into space
  • Inability to recognize familiar surroundings

Fibromyalgia sensory symptoms

  • Sensitivity to odors
  • Sensitivity to pressure changes, temperature, and humidity
  • Sensitivity to light
  • Sensitivity to noise
  • Night driving difficulty
  • Sensory overload

Fibromyalgia emotional symptoms

  • Panic attack
  • Depression
  • Tendency to cry easily
  • Free-floating anxiety
  • Mood swings
  • Unaccountable irritability

Fibromyalgia heart-related symptoms

  • Mitral valve prolapse
  • Irregular heartbeat
  • Pain that mimics heart attack, frequently from costochondritis

Skin, hair, and nail symptoms in fibromyalgia

  • Pronounced nail ridges
  • Nails that curve under
  • Mottled skin
  • Bruising or scarring easily
  • Hair loss
  • Tissue overgrowth

Fibromyalgia miscellaneous symptoms

  • Hemorrhoids
  • Nose bleeds

Complete fibromyalgia symptoms checklist

In order to better determine if you have fibromyalgia or another condition, use the following checklist and indicate on a scale of one to 10 how severe each symptom is when it occurs.


  • Fatigue worsened by physical exertion or stress
  • Activity level decreased to less than 50 percent of pre-illness activity level
  • Recurrent flu-like illness
  • Sore throat
  • Hoarseness
  • Tender or swollen lymph nodes (glands), especially in neck and underarms
  • Shortness of breath (air hunger) with little or no exertion
  • Frequent sighing
  • Tremor or trembling
  • Severe nasal allergies (new allergies or worsening of previous allergies)
  • Cough
  • Night sweats
  • Low-grade fevers
  • Feeling cold often
  • Feeling hot often
  • Cold extremities (hands and feet)
  • Low body temperature (below 97.6 F)
  • Low blood pressure (below 110/70)
  • Heart palpitations
  • Dryness of eyes and/or mouth
  • Increased thirst
  • Symptoms worsened by temperature changes
  • Symptoms worsened by air travel
  • Symptoms worsened by stress


  • Headache
  • Tender points or trigger points
  • Muscle pain
  • Muscle twitching
  • Muscle weakness
  • Paralysis or severe weakness of an arm or leg
  • Joint pain
  • TMJ (temporomandibular joint) syndrome
  • Chest pain


  • Light-headedness: feeling “spaced out”
  • Inability to think clearly (“brain fog”)
  • Seizures
  • Seizure-like episodes
  • Syncope (fainting) or blackouts
  • Sensation that you might faint
  • Vertigo or dizziness
  • Numbness or tingling sensations
  • Tinnitus (ringing in one or both ears)
  • Photophobia (sensitivity to light)
  • Noise intolerance


  • Feeling spatially disoriented
  • Disequilibrium (balance difficulty)
  • Staggering gait (clumsy walking, bumping into things)
  • Dropping things frequently
  • Difficulty judging distances (e.g. when driving, placing objects on surfaces)
  • “Not quite seeing” what you are looking at


  • Hypersomnia (excessive sleeping)
  • Sleep disturbance: unrefreshing or non-restorative sleep
  • Sleep disturbance: difficulty falling asleep
  • Sleep disturbance: difficulty staying asleep (frequent awakenings)
  • Sleep disturbance: vivid or disturbing dreams or nightmares
  • Altered sleep/wake schedule (alertness/energy best late at night)


  • Depressed mood
  • Suicidal thoughts
  • Suicide attempts
  • Feeling worthless
  • Frequent crying
  • Feeling helpless and/or hopeless
  • Inability to enjoy previously enjoyed activities
  • Increased appetite
  • Decreased appetite
  • Anxiety or fear when there is no obvious cause
  • Panic attacks
  • Irritability, overreaction
  • Rage attacks: anger outbursts with little or no cause
  • Abrupt, unpredictable mood swings
  • Phobias (irrational fears)
  • Personality changes


  • Eye pain
  • Changes in visual acuity (frequent changes in ability to see well)
  • Difficulty with accommodation (switching focus from one thing to another)
  • Blind spots in vision


  • Sensitivities to medications (unable to tolerate “normal” dosage)
  • Sensitivities to odors (e.g., cleaning products, exhaust fumes, colognes, hair sprays)
  • Sensitivities to foods
  • Alcohol intolerance
  • Alteration of taste, smell, and/or hearing


  • Frequent urination
  • Painful urination or bladder pain
  • Prostate pain
  • Impotence
  • Endometriosis
  • Worsening of premenstrual syndrome (PMS)
  • Decreased libido (sex drive)


  • Stomach ache, abdominal cramps
  • Nausea
  • Vomiting
  • Esophageal reflux (heartburn)
  • Frequent diarrhea
  • Frequent constipation
  • Bloating, intestinal gas
  • Decreased appetite
  • Increased appetite
  • Food cravings
  • Weight gain (____ lbs)
  • Weight loss (____ lbs)


  • Rashes or sores
  • Eczema or psoriasis


  • Hair loss
  • Mitral valve prolapse
  • Cancer
  • Dental problems
  • Periodontal (gum) disease
  • Aphthous ulcers (canker sores)


  • Difficulty with simple calculations (e.g., balancing checkbook)
  • Word-finding difficulty
  • Using the wrong word
  • Difficulty expressing ideas in words
  • Difficulty moving your mouth to speak
  • Slowed speech
  • Stuttering, stammering
  • Impaired ability to concentrate
  • Easily distracted during a task
  • Difficulty paying attention
  • Difficulty following a conversation when background noise is present
  • Losing your train of thought in the middle of a sentence
  • Difficulty putting tasks or things in proper sequence
  • Losing track in the middle of a task (remembering what to do next)
  • Difficulty with short-term memory
  • Difficulty with long-term memory
  • Forgetting how to do routine things
  • Difficulty understanding what you read
  • Switching left and right
  • Transposition (reversal) of numbers, words, and/or letters when you speak
  • Transposition (reversal) of numbers, words, and/or letters when you write
  • Difficulty remembering names of objects
  • Difficulty remembering names of people
  • Difficulty recognizing faces
  • Difficulty following simple written instructions
  • Difficulty following complicated written instructions
  • Difficulty following simple oral (spoken) instructions
  • Difficulty following complicated oral (spoken) instructions
  • Poor judgment
  • Difficulty making decisions
  • Difficulty integrating information (putting ideas together to form a complete picture or concept)
  • Difficulty following directions while driving
  • Getting lost in familiar locations when driving
  • Feeling too disoriented to drive

Tender points in fibromyalgia

As previously mentioned, there are 18 tender points that doctors may check to determine fibromyalgia. The following are those 18 tender points.

Occiput (2) – at the sub-occipital muscle insertions (near the base of the skull)

Low cervical (2) – at the anterior aspects of the inter-transverse spaces at C5-C7 (the lower vertebra of the neck)

Trapezius (2) – at the midpoint of the upper border (the neck, mid back, and upper back muscles between the shoulder blades)

Supraspinatus (2) – at origins, above the scapula spine near the medial border

Second rib (2) – upper lateral to the second costochondral junction (the insertion of the second rib)

Lateral epicondyle (2) – 2 cm distal to the epicondyles (the side of the elbow)

Gluteal (2) – in upper outer quadrants of buttocks in anterior fold of muscle (the upper and outer muscles of the buttocks)

Greater trochanter (2) – posterior to the trochanteric prominence (the upper part of the thigh)


Knee (2) – at the medial fat pad proximal to the joint line (the middle of the knee joint)

Doctors may still use these tender points along with a physical exam and other testing to rule out other health conditions in order to properly diagnose fibromyalgia.

Although doctors are still unaware of the underlying cause of tender points, they do know that these areas are not random and occur in predictable areas on the body. This helps diagnosing fibromyalgia because all patients share the same tender points.

Author Bio

Emily Lunardo studied medical sociology at York University with a strong focus on the social determinants of health and mental illness. She is a registered Zumba instructor, as well as a Canfit Pro trainer, who teaches fitness classes on a weekly basis. Emily practices healthy habits in her own life as well as helps others with their own personal health goals. Emily joined Bel Marra Health as a health writer in 2013.


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Fibromyalgia symptoms in men often go undiagnosed

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