Which stage of fibromyalgia affects you the most?

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Pain sensations: Your tend to experience

Variable tight pain that is worse with cold and migrates from one area to the next

Constant pain that is worse in humid weather or with food sensitivities

Dull pain that is worse with stress and lack of movement

Sharp or stabbing pain that is worse in the early morning, morning stiffness, or pain that wakes you up in the middle of the night

Pain that is worse with exertion

Pain that is associated with menstruation or menopause

Tight pain that is accompanied with cold limbs

Burning pain that is worse in the evening

Your pain tends to manifest:

I have a history of: (check all that apply)

My skin tends to get:

Cold in the back of the neck and shoulders, with neck tension

Pimples or boils on the insides of the legs, toe nail fungus

A blotchy facial complexion

Slight purple or blue color in the toes, finger, or tongue. I tend to get spider veins or varicose veins

Slow healing of sores, acne that doesn’t form a white head, bruise easily

Very pale or anemic facial complexion

Skin tends to sag

Skin tends to be dry

My tongue tends to be:

Pale with a thick white coating

Red or pink with a yellow coating

Spotted on the sides with a red tip

Slightly purple with engorged and dark colored veins beneath the tongue

Pale tongue, that is fat in the mouth with scallops from where the tongue presses against the teeth

Pale tongue and pale lips

Pale, fat, and moist tongue coating

Red tongue, with cracks or fissures in the tongue body

Fluid metabolism

I tend to not feel thirsty

I feel thirsty, but I don’t drink enough water

My thirst and urination fluctuate

I don’t drink or urinate very much

I enjoy warm liquids and have frequent urination

Appetite and bowel movements

Poor appetite with sticky or loose stools without a strong scent

Poor appetite with sticky or loose stools with a strong scent

Eating more with stress and/or stools alternate between constipation and loose. Possible history of gall bladder pain or removal

Low appetite and infrequent bowel movements

Low appetite and undigested food in the stool, low scent, possible constipation

Infrequent, dry stools

Poor appetite associated with feeling cold in the stomach

Frequent, dry stools

Reproductive health

I tend to have jock itch or frequent yeast infections, white vaginal discharge with a fishy odor, lower libido

I tend to have jock itch or frequent yeast infections, yellow vaginal discharge with a strong odor

I tend to have low libido with stress, breast distention near menstruation, menstrual irregularity, erectile dysfunction, vericocele

History of uterine fibroids, hysterectomy, vericocele, late menstruation or flooding menstruation with dark clots

Fatigue associated with sex. Wilting erection, shortness of breath and poor sexual endurance

History of short or scanty menstruation or fibromyalgia symptoms coming after giving birth

Indifferent toward sex or very low libido

Vaginal dryness, low sperm count, wet dreams

My breathing tends to be:

With nasal obstruction, wheezing, or mucus

I snore at night or have sleep apnea, or now have a CPAP

I tend to sigh

I get shortness of breath, am easily winded, tendency to yawn

Difficult to take deep breaths, forget to breathe, tendency to yawn

Shallow breathing, tendency to yawn

Sleep and dreams

Dreams of fighting, or nasal obstruction at night

Sluggishness or napping throughout the day

Difficulty getting to sleep, tossing and turning

Pain or stiffness associated with sleeping

Sleeping with the mouth or eyes open, preference for sleeping on the left side

Waking up in the middle of the night or nightmares, preference for sleeping on the right side

Waking up in the night to urinate

Sweating at night or sensations of heat

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Which stage of fibromyalgia affects you the most?

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