A new study by researchers from the Centers for Disease Control and Prevention suggests there may be an association between chronic fatigue syndrome in women and early menopause, as well as other gynecologic conditions.
Chronic fatigue syndrome (CFS) is a condition in which individuals experience continuous, severe tiredness, even after bed rest.
As well as extreme fatigue, symptoms of the condition include muscle pain, joint pain, unrefreshing sleep, poor memory and concentration, tender lymph nodes in the armpit or neck, headache and frequent or recurring sore throat. A person is normally diagnosed with CFS if they have experienced at least four of these symptoms for 6 months or more.
While CFS can affect children, it is more common in adults – particularly women. Women are two to four times more likely to develop CFS than men, and onset is most common among women in their 40s.
Now, the research team – including Dr. Elizabeth Unger, chief of the Chronic Viral Disease Branch at the Centers for Disease Control and Prevention (CDC) – says their findings may explain why.
For their study, recently published in the journal Menopause, Dr. Unger and colleagues analyzed 157 women who were part of a US population-based case-control study conducted between 2004 and 2009.
Of the women, 84 had CFS and 73 were healthy controls. All women were required to complete a gynecologic health questionnaire.
From comparing the two groups, the researchers found that women with CFS were more likely to experience some signs of early menopause – defined as undergoing menopause before the age of 45 – and other gynecologic conditions, compared with healthy controls.
Women with CFS were 12 times more likely to experience non-menstruation related pelvic pain – such as pelvic floor dysfunction, interstitial cystitis/painful bladder syndrome (IC/PBS) and irritable bowel syndrome (IBS) – than women without CFS.
More frequent excessive bleeding was reported among women with CFS, at 74% compared with 42% of women without CFS. Women with CFS also reported more bleeding between periods and more missed periods, and they were also more likely to use hormones for non-contraception purposes, such as to treat menopausal symptoms, bone loss or irregular periods.
In addition, the team found that 66% of women with CFS had undergone at least one gynecologic surgical procedure – with hysterectomy being most common – compared with 32% of women without CFS. Women with CFS were more likely to cite excessive bleeding as the reason for undergoing hysterectomy than controls.
Women with CFS were also more likely to undergo a hysterectomy at a much younger age than controls, and 71% of women had the procedure prior to CFS onset.
The researchers note that past studies have associated CFS with gynecologic conditions, such as endometriosis and IC/PBS, as well as pelvic pain. They say theirs, however, is the first study to link CFS with early menopause, and health care providers should take note of this finding.
Dr. Margery Gass, director of The North American Menopause Society (NAMS), adds:
“CFS can take a tremendous toll on women’s lives at midlife and on our society and health care system. 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.”
The team says their findings may also help explain why CFS is most common among women in their 40s.
Though the researchers do not know exactly what drives the link between CFS and early menopause, they hypothesize that abnormalities or early reductions in sex hormones may play a role. They say this theory warrants further research.
In October 2014, Medical News Today reported on a study published in the journal Radiology, in which researchers identified brain abnormalities in patients with CFS.