context: If you have fibromyalgia and are thinking about getting pregnant, it's important to learn all you can about both conditions. Sometimes, symptoms of fibromyalgia -- such as pain, fatigue, and depression -- are thought to be signs of the pregnancy itself. As a result, they may be undertreated. In addition, the added stress of having a baby may cause fibromyalgia symptoms to flare, making you feel much worse. Managing fibromyalgia during pregnancy is possible. But you need to spend time learning about the effects of pregnancy on symptoms of fibromyalgia syndrome ( FMS). You also need to stay in touch with your fibromyalgia specialist when symptoms flare. It is also important to visit your ob-gyn for routine prenatal care visits. During a visit, your doctor may screen you for depression and work with you to treat these symptoms. With pregnancy, there's a tremendous increase in the amount of hormones in your body. Along with weight gain, your body is out of balance, and your shape takes a different form. Most women experience nausea and fatigue, especially during the first three months of pregnancy. Is it any wonder that fibromyalgia symptoms are often misdiagnosed and thought to be a normal part of pregnancy? There are few studies on fibromyalgia in pregnant women. However, a study at Temple University found that women with fibromyalgia had more symptoms of pain during pregnancy than women who did not have fibromyalgia. Also, fibromyalgia symptoms seemed to be exacerbated during pregnancy. Pregnant women with fibromyalgia may experience significant pain, fatigue, and psychological stress, especially in the first three months. Pregnant or not, stress -- both physical and emotional -- is known to trigger fibromyalgia. Considering all that's involved with pregnancy, labor, and delivery, it's obvious that pregnancy is a time of high stress. With pregnancy, there are changes in the levels of estrogen, progesterone, and other hormones. Also, since the time after a pregnancy can be difficult for mothers -- even those without fibromyalgia -- it's important to be aware of the possible increase in pain and other symptoms that may occur after giving birth. At this time, no fibromyalgia medications are completely safe to use during pregnancy. In fact, doctors recommend that women with fibromyalgia go off of painkillers and antidepressants before they become pregnant. However, be sure you talk with your doctor before you stop any medicines. To avoid letting fibromyalgia interfere with pregnancy, know what steps you can take to ease the symptoms. Then seek support from your doctors, family members, and friends. Treatments for pregnant women with fibromyalgia may include massage, exercise, yoga, meditation, and rest. If you suffer with fatigue and ache all over, make sure you rest 20 to 30 minutes at least two or three times a day. To ease the achiness of tender point pain, try moist heat applications twice a day. A warm shower or bath is a good way to apply moist heat. Just make sure that the water temperature is 100 degrees Fahrenheit or lower and limit use to 15 -20 minutes at a time. Water that is warm enough to raise your body temperature to 101 ° F or higher, may cause birth defects. Also, use gentle stretching exercises and exercises recommended by your doctor for relief. Exercise helps keep you fit. It strengthens muscles, keeps joints flexible, and boosts mood by increasing serotonin in your body. Serotonin is one of the neurotransmitter that scientists have found to be related to fibromyalgia. Neurotransmitters are chemicals that send specific messages from one cell to another. While only a small percentage of serotonin is located in the brain, this neurotransmitter is believed to play a vital role in mediating moods. Too much stress can lead to permanently low levels of serotonin. That, in turn, can lead to aggression and feelings of depression. Lack of exercise can aggravate low serotonin levels. On the other hand, increased levels of serotonin in the brain are associated with a calming, anxiety reducing effect. In some cases they are also associated with drowsiness. Having stable function in the brain circuits that use serotonin to send messages is linked with a positive mood. Talk to your health care provider about the level of activity that is right for you. It appears that women may have a greater sensitivity to changes in serotonin. Mood swings during the menstrual cycle or menopause or following the birth of a baby are induced by the action of hormones on neurotransmitters. Various factors can have a positive effect on serotonin functioning. These include sunlight, certain carbohydrate foods, some hormones, and exercise. Exercise acts as nature's tranquilizer, helping to boost serotonin activity in the brain. Studies show that exercise also triggers the release of epinephrine and norepinephrine, which are known to boost alertness. Along with stretching and normal daily activities during pregnancy, consider exercising in a warm swimming pool. The heat might help ease the fibromyalgia pain while the stretching and other low-impact exercise can keep your muscles and joints flexible and strong. The water temperature should feel comfortable but not hot. In a pool, water temperatures from 83 to 88 degrees Fahrenheit are usually comfortable for exercise. But if you're pregnant, ask your doctor before exercising in a warm pool. Do not use a whirlpool bath or spa or hot water in your bath during pregnancy. Doing so could harm fetal development. Other exercises that might be helpful include riding a stationary bike, tai chi, and yoga. But remember that some yoga positions will need to be adapted for your changing shape during pregnancy. For women who ache all over because of fibromyalgia during pregnancy, acetaminophen ( Tylenol and others) is often recommended. Still, it's best to avoid all medications without approval from your fibromyalgia doctor and obstetrician. Learn all you can about fibromyalgia and pregnancy before you get pregnant. Then, you will be well prepared once you do.