Endometriosis Linked to Other Diseases

Fibromyalgia, Chronic Fatigue Common in Women With Endometriosis

From the WebMD Archives

Sept. 26, 2002 -- Women with endometriosis are at increased risk for a host of other diseases including chronic fatigue syndrome, multiple sclerosis, lupus, underactive thyroid, and rheumatoid arthritis, according to new government findings.

Researchers from the National Institute of Child Health and Human Development (NICHHD) report data from a survey of endometriosis patients in the latest issue of the journal Human Reproduction. One in five patients said they'd been diagnosed with a second disease, and one in three of these patients reported having chronic fatigue syndrome or fibromyalgia.

This is the first study to link various immune system or hormonal diseases to endometriosis, a common condition in which uterine tissue grows outside the womb. As many as one in 10 women of reproductive age has endometriosis, which can result in disabling pelvic pain, irregular bleeding, and infertility.

"These findings confirm for the first time what we have been hearing from members for years," says Mary Lou Ballweg, Endometriosis Association president. "We have been following immune disorders and endometriosis since 1980, but this is the first real, strong data to show a link," she tells WebMD.

Close to 3,700 patients completed the Endometriosis Association survey, which also showed an average delay of almost a decade between the onset of endometriosis symptoms and diagnosis. Most women with the disease are diagnosed in their mid-to-late 20s, but 38% of the women surveyed began having symptoms before age 15.

"Unfortunately, most pediatricians and adolescent medical specialists don't take pelvic pain seriously, and they don't think about endometriosis," NICHHD researcher Pamela Stratton, MD, tells WebMD. "Even gynecologists are often surprised to find adolescents with endometriosis, but the truth is that it is very common."

Compared with the general population of women, Stratton and colleagues found that women with endometriosis were more than 100 times as likely to have chronic fatigue syndrome, seven times as likely to have disease related to underactive thyroid, and twice as likely to have the muscular disorder fibromyalgia.

Autoimmune inflammatory diseases such as lupus, Sjogren's Syndrome, rheumatoid arthritis, and multiple sclerosis were also more common in women with the endometriosis, as were allergies, asthma, and eczema. Some 61% of the women surveyed had allergies, compared with 18% of the U.S. population, and 12% of them had asthma compared with 5% of the U.S. population. And in endometriosis patients with another endocrine disorder or a chronic pain or fatigue syndrome, 72% and 88%, respectively, had asthma.

The findings should serve to alert patients and their doctors to the link between endometriosis and diseases known or suspected to be associated with immune disorders, Stratton says.

"If a woman has endometriosis, she should probably be screened for other autoimmune diseases," she says. "And if she has an autoimmune disease and pelvic pain, especially at a young age, she should be screened for endometriosis."

Ballweg says she is confident that the latest findings will spur more research into the immune system's role in endometriosis and other diseases commonly seen among women with the disorder. -->