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Cited by 22Fibromyalgia and Chronic Fatigue Syndrome ResearchEndometriosis Research and TreatmentPlant and fungal interactions

Endometriosis as a Comorbid Condition in Chronic Fatigue Syndrome (CFS): Secondary Analysis of Data From a CFS Case-Control Study

Open access
Boneva, Roumiana S., Lin, Jin-Mann S., Wieser, Friedrich, Nater, Urs M., Ditzen, Beate, Taylor, Robert N., Unger, Elizabeth R.·2019·Frontiers in Pediatrics
DOI 10.3389/fped.2019.00195PMC PMC6537603
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Abstract

Background. Endometriosis (EM) is a recognized co-morbid condition in women with chronic fatigue syndrome (CFS). This analysis evaluates the impact of EM on the health of women with CFS by comparing selected health characteristics and laboratory parameters in women with CFS with and without EM (CFS+EM and CFS-only). Methods. This secondary analysis included all 36 women with CFS from a cross-sectional study of CFS in Wichita, KS, conducted between 2002 and 2003. The health characteristics and laboratory parameters of interest included functioning, fatigue, CFS-related symptoms, gynecologic history, routine laboratory parameters, inflammatory markers, cortisol levels, allostatic load, and sleep parameters (overnight polysomnography). We used parametric or nonparametric tests to compare group differences in the selected health characteristics and laboratory parameters. For examining the association between EM and variables of interest, logistic regression models were performed and odds ratios (OR) with 95% confidence intervals (CI) were reported for the magnitude of associations. Statistical significance was set at 0.05 (two-sided). Results. The mean age of this study sample was 50.9 years. Of women with CFS, 36.1% reported having EM. Age and body mass index (BMI) did not differ between CFS+EM and CFS-only groups. When examining the impact of EM, compared to women with CFS-only, women with both CFS and EM were more likely to report chronic pelvic pain [OR=9.00 (95% CI, 1.47-55.25)] and hysterectomy [OR=10.3 (1.82-58.39)], had more CFS symptoms (6.8±0.3 vs. 5.5±0.3, p=.02), younger mean age at menopause onset (36.4 ±3.0 vs 47.0±2.7 years, p=.03), higher mean number of obstructive apnea episodes per hour (20.3 vs. 4.4, p=0.05) and reported more negative life events (15.8 vs. 4.4, p=0.05). Other parameters did not differ significantly between the two groups. Conclusions. We found that more than a third of women with CFS reported endometriosis as a comorbid condition. The endometriosis comorbidity was associated with chronic pelvic pain, earlier menopause, hysterectomy, and more CFS-related symptoms. However, endometriosis in women with CFS did not appear to further impact functioning, fatigue, inflammatory markers or other laboratory parameters. Further investigations including younger women are warranted.

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  • In both groups of the French study, sexual traumatisation referred to in anamnesis was associated with an increased experience of pain.

    “but in both groups, sexual traumatisation referred to in anamnesis was associated with an increased experience of pain (similar to [12]).”

    From Endometriosis: patient–doctor communication and psychological counselling (2023) · cites this paper as [12]

    The Discussion (Psychological Variables; page unavailable) says previous studies suggest childhood stress may be linked to chronic pain syndromes. But this paper does not report that sexual trauma was associated with greater pain in either of its groups; its Results (Tables 2 and 3; pages unavailable) report sexual-abuse scores and pelvic-pain frequency separately. The French study’s finding about both groups is the citing authors’ own finding, not a finding attributed to this source. (LLM, conf=0.77)

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  • Traumatic experiences generally reduce pain tolerance, and persons affected by early-childhood and/or repeated traumas are more likely to develop a pain disorder.

    “we need to bear in mind that traumatic experiences will generally reduce pain tolerance and that persons affected by early-childhood and/or repeated traumas will be more likely to develop a pain disorder.”

    From Endometriosis: patient–doctor communication and psychological counselling (2023) · cites this paper as [12]

    The Discussion’s “Psychological Variables” section says previous studies suggest childhood stress may be linked to chronic pain syndromes. It does not say trauma generally reduces pain tolerance or that repeated trauma increases the likelihood of a pain disorder. The paper also found no difference in childhood stress between its two CFS groups. (LLM, conf=0.84)

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Research works printed but not linked: 3

  1. [1]IOM (Institute of Medicine) Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining An Illness. Washington, DC: The National Academies Press (2015). 25695122
  2. [3]IOM (Institute of Medicine) Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research. Washington, DC: The National Academies Press (2011). 22553896
  3. [31]Spielberger CD Manual for the State-Trait Anxiety Inventory (STAI). Palo Alto, CA: Consulting Psychologists Press (1983).

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Authors
Boneva, R. S., Lin, J.-M. S., Wieser, F., Nater, U. M., Ditzen, B., Taylor, R. N., & Unger, E. R.
Affiliations
  • Centers for Disease Control and Prevention (US)
  • Emory University (US)
Corresponding author
Boneva, Roumiana S.
ORCID
Venue
Frontiers in Pediatrics
Publisher
Frontiers Media SA
Published
2019-05-21
Volume
7
Pages
195-195
ISSN
2296-2360 (ISSN-L)
DOI
10.3389/fped.2019.00195
PMC
PMC6537603
OpenAlex
W2946664614
Cited by
22
References
44
Citations by year
2026: 2 · 2025: 2 · 2024: 2 · 2023: 6 · 2022: 6 · 2021: 1 · 2020: 2 · 2019: 1
FWCI
1.99
Type
journal article
Language
en
Open access
Licence
Locations
  • Frontiers in Pediatrics (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Funders
Chinese Center for Disease Control and Prevention
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
  • Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
  • Life Sciences › Agricultural and Biological Sciences › Ecology, Evolution, Behavior and Systematics › Plant and fungal interactions
Keywords
OSI, chronic fatigue syndrome, comorbidities, chronic pelvic pain, hysterectomy, age at menopause, obstructive sleep apnea, negative life events, cortisol, allostatic load, inflammatory markers, women's health, polysomnography, laboratory parameters, fatigue, body mass index, Wichita, Kansas, case-control study, secondary analysis

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