Early menopause and other gynecologic risk indicators for chronic fatigue syndrome in women

Abstract

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.

Illness progression in chronic fatigue syndrome: a shifting immune baseline

“…Nonetheless we found significantly higher IL-6 expression in the older ME/CFS subgroup compared to the middle-aged ME/CFS group. Though these changes could not be associated directly with menopausal status here, this observation nonetheless aligns with recent work by Boneva et al [ 47 ] where ME/CFS was associated with early hysterectomy and/or menopause, linking this condition to the reduction or depletion of endogenous female sex hormones and to the possibility that menopause-like changes in immune signature may constitute an inherent component of ME/CFS pathology. Such a link has been observed in other complex illnesses with immune involvement [ 48 ].…”

Leveraging Prior Knowledge of Endocrine Immune Regulation in the Therapeutically Relevant Phenotyping of Women With Chronic Fatigue Syndrome

“…These hormones are important regulators of the menstrual cycle, which is known to be dysregulated in women with ME/CFS. 50 These results highlight the importance of considering cyclic fluctuations in hormonal regulation when considering complex metabolic disorders such as ME/CFS, especially in women. Interestingly, one case of ME/CFS associated with membranous dysmenorrhea spontaneously resolved after the discontinuation of hormonal contraceptive treatment.…”

Association of chronic fatigue syndrome with premature telomere attrition

“…Low estrogen levels were reported to be associated with short telomeres in women [ 36 ]. CFS has a higher prevalence in females and gynecologic factors such as early menopause and hysterectomy have been associated with CFS [ 20 , 37 , 38 ]. These prior findings along with our observation of short telomeres in female participants < 45 years old with CFS, CFS-X and ISF suggest the need for further studies on the dynamics of telomere length in relation to age, sex hormones, gynecological history and the onset of CFS.…”

“…Data came from the follow-up phase of a two-wave population-based longitudinal study of CFS and fatiguing illness in Georgia, USA, conducted in 2004 and 2009 [ 2 , 20 ]. The study was approved by the Institutional Review Boards of the Centers for Disease Control & Prevention, Atlanta, GA and Abt Associates, Atlanta, GA. All participants gave written informed consent for participating in the study.…”