Occam’s Menopause

How can thousands of people across the country all have the same symptoms? This is a question I am often asked regarding Morgellons, and my response has generally been that they don’t, the symptoms are varied, and where the symptoms are similar, there are many known causes for those symptoms.

In my previous article, “Occam’s Hot Tub“, I posited a possible series of events that might lead to someone thinking they had Morgellons, when in reality they had hot tub folliculitus, neurotic excoriations and fiberglass splinters.

But let’s consider a much more common possible cause, one that could account for a very large percentage of cases. Consider if the symptoms of menopause match the symptoms of Morgellons.

First, remember who these thousands of people are. They are the people who filled in an internet form, first at the MRF, and now at OSU. The form is really lacking in epidemiologically useful questions, but does ask which of the following 12 Morgellons symptoms you have:

Lesions or sores
Fibers or filaments on skin
Granules or specks on the skin
Itching or stinging
Hair loss
Joint pain
Fatigue
Biting or crawling feeling on the skin
Mood disorder
Memory or concentration problems
(ex: ‘brainfog’, short term memory loss)
Vision problems
Edema or swelling

Skipping the first three for now (don’t worry, I’ll address them later), let us look at the rest, grouping them as appropiate:

Itching or stinging, Biting or crawling feeling on the skin
http://www.dvmen.org/dv-135.htm
“Formication, the feeling that ants or other insects are crawling on their skin, affects about 20% of women during perimenopause and menopause. Formication can cause a woman to scratch herself raw.”
“many women experience severe itching during perimenopause that is unrelated to formication”
http://www.healthsquare.com/fgwh/wh1ch29.htm
Some women experience a prickling, itching sensation on the skin, known as formication. It has been called “crawling skin” because it feels as though tiny insects are marching along your body.”
Menopause: A guide for Women and Those who Love them, Berg and Garcia, 1992, p.76
“Skin tingling or a feeling that unseen insect are crawling across your skin is called formication. It is a symptom of menopausal distress. […] 20 percent of menopausal women report the problem”

Joint Pain
http://www.breastcancer.org/cmty_trans_2002_3_21.html
“Symptoms of menopause you may be experiencing include: […] Muscle and joint pain
Joint pain is a common complaint in many women and men as we reach middle age.”

Fatigue, Mood disorder, Memory or concentration problems
http://www.merck.com/mrkshared/mmanual/section18/chapter236/236a.jsp
“Psychologic and emotional symptoms–including fatigue, irritability, insomnia, inability to concentrate, depression, memory loss, headache, anxiety, and nervousness–may be related to estrogen deprivation and the stress of aging and changing roles. Sleep disruption by recurrent hot flushes contributes to fatigue and irritability.”
http://en.wikipedia.org/wiki/Menopause#Symptoms
mood disturbance, irritability, fatigue, decreased libido, memory loss

Vision Problems
http://www.healthsquare.com/fgwh/wh1ch29.htm
Visual capacity, such as the ability to read road signs at night, has been reported to decline by a sample of menopausal women.”
http://www.ejfi.org/family/family-60.htm#menopause
Changes in visual acuity requiring changes in eyeglass prescriptions or other vision problems.”

Hair Loss
http://www.womentowomen.com/SYMhairlossdryskin.asp
“Approximately one-third of menopausal women report noticeable hair loss (called “alopecia”)”
http://www.power-surge.com/educate/hairloss.htm
“The most common cause of hair loss is low thyroid function, which is common among menopausal women.

Edema or swelling
http://www.epigee.org/menopause/weight_gain.html
Water retention and menopause often go hand in hand since water weight and bloating are caused by decreased progesterone levels.”
http://www.ezinearticles.com/?Menopause-and-Water-Retention&id=223203
Water retention is excessive accumulation of fluid in the body. It occurs in women during menopause or perimenopause when they take estrogen replacement hormones.”

So, 9 out of 12 symptoms are common symptoms of menopause. We can easily make it 10 by including lesions, since “Formication can cause a woman to scratch herself raw.”, but also since a “lesion” can be almost any abnormal change involving any tissue or organ. The most common skin lesion is acne:
http://www.acne.org/women_and_acne.html
“women undergoing menopause and post-menopause may also experience hormonal acne
http://www.menopauseinsight.com/menopause/menopause-acne.aspx
“Menopausal and post-menopausal women experience a dramatic decrease in estrogen levels, and an increase in testosterone. This causes the skin glands to produce more oil than they usually do, and as a result, more acne breakouts occur.”

So all we are left with is fibers and specks on the skin. If you look, you will find them. I have fibers and specks on my skin right now.

A slightly better survey of Morgellons believers can be found at:
http://www.usp-db.com/

In August 2006, this only had 305 respondents, but of those, 76% are women, and 80% are in the age range 35-60 (the age range of menopause onset), with the highest number in the 50-54 range – the average age of menopause onset)

So, all the symptoms of Morgellons on one internet survey are practically identical to the symptoms of menopause, and the other survey indicates that the vast majority of people with Morgellons are women of menopausal age.

Does this mean that all cases of Morgellons are actually menopause? Obviously not, we’ve got a few men there, and several people with highly odd symptoms, and some children. But the correlation is so staggeringly high, that it seems very likely that as many as half of those 5000+ people who say they have symptoms of morgellons actually have symptoms of menopause.