Increased gynaecological problems

A new study, just reported online in the journal Menopause, links ME/CFS with early menopause (most often due to hysterectomy), along with other gynaecological problems and pelvic pain.

The researchers examined 84 CFS patients and 73 healthy women from a case-control study in Georgia, USA. The women with CFS reported significantly more gynaecological conditions: menopause status (62% in CFS versus 37% in controls); earlier average age at menopause onset (38 versus 49 years, commonly because of hysterectomy), excessive menstrual bleeding (74% versus 42%), non-menstrual pelvic pain (26% versus 3%), and a range of other gynaecologic difficulties (see abstract below). They’d also had more surgical operations than the healthy women, most frequently hysterectomy (55% versus 19%) which occurred before the onset of ME/CFS symptoms in a majority of the patients.

As the North American Menopause Society explains in a press release, “CFS can take a tremendous toll on women’s lives at midlife and on our society…Being aware of the association of CFS and earlier menopause can help providers assist women in sorting out symptoms of CFS from symptoms of menopause.”


OBJECTIVE: This study aims to examine whether gynecologic conditions are associated with chronic fatigue syndrome (CFS).

METHODS: This study includes a subset of 157 women from a population-based case-control study in Georgia, United States, conducted in 2004-2009. Gynecologic history was collected using a self-administered questionnaire. Crude odds ratios (ORs) with 95% CIs and ORs adjusted for body mass index and other covariates, where relevant, were estimated for gynecologic conditions between 84 CFS cases and 73 healthy controls.

RESULTS: Cases and controls were of similar age. Women with CFS reported significantly more gynecologic conditions and surgical operations than controls: menopause status (61.9% vs 37.0%; OR, 2.37; 95% CI, 1.21-4.66), earlier mean age at menopause onset (37.6 vs 48.6 y; adjusted OR, 1.22; 95% CI, 1.09-1.36), excessive menstrual bleeding (73.8% vs 42.5%; adjusted OR, 3.33; 95% CI, 1.66-6.70), bleeding between periods (48.8% vs 23.3%; adjusted OR, 3.31; 95% CI, 1.60-6.86), endometriosis (29.8% vs 12.3%; adjusted OR, 3.67; 95% CI, 1.53-8.84), use of noncontraceptive hormonal preparations (57.1% vs 26.0%; adjusted OR, 2.95; 95% CI, 1.36-6.38), nonmenstrual pelvic pain (26.2% vs 2.7%; adjusted OR, 11.98; 95% CI, 2.57-55.81), and gynecologic surgical operation (65.5% vs 31.5%; adjusted OR, 3.33; 95% CI, 1.66-6.67), especially hysterectomy (54.8% vs 19.2%; adjusted OR, 3.23; 95% CI, 1.46-7.17). Hysterectomy and oophorectomy occurred at a significantly younger mean age in the CFS group than in controls and occurred before CFS onset in 71% of women with records of date of surgical operation and date of CFS onset.

CONCLUSIONS: Menstrual abnormalities, endometriosis, pelvic pain, hysterectomy, and early/surgical menopause are all associated with CFS. Clinicians should be aware of the association between common gynecologic problems and CFS in women. Further work is warranted to determine whether these conditions contribute to the development and/or perpetuation of CFS in some women. PMID: 25647777 [PubMed – as supplied by publisher]

REFERENCE: Early menopause and other gynecologic risk indicators for chronic fatigue syndrome in women. Boneva RS(1), Lin JM, Unger ER. Centers for Disease Control and Prevention, Atlanta, GA. Menopause. 2015 Feb 2. [Epub ahead of print]

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