Gynecological history in chronic fatigue syndrome: A population-based case-control study

Background: Chronic fatigue syndrome (CFS) affects disproportionately more women than men, and the condition is more common at perimenopause. We examined gynecological history events as risk factors for CFS. Methods: In a case-control study from a randomly selected population sample from Wichita, Kansas, 36 women with CFS and 48 nonfatigued controls, of similar age, race, and body mass index (BMI), answered a structured gynecological history questionnaire. Results: CFS cases and controls had the same mean age (51 years) and age at menarche (12 years). Overall, a greater proportion of women with CFS than controls reported pelvic pain unrelated to menstruation (22.2% vs. 1.7%, p=0.004), endometriosis (36.1% vs. 16.7, %, p=0.046), and periods of amenorrhea (53.9 % vs. 46.2%, p=0.06). Compared to controls, women in the CFS group had a higher mean number of pregnancies (2.8 vs 2.0, p=0.05) and gynecological surgeries (1.8 vs. 1.1, p=0.05). Similar proportions of the CFS (69.4%) and control (72.9%) groups were menopausal. Although menopausal women in the CFS and control groups had similar mean age (55.5 and 55.8, respectively), menopause occurred about 4.4 years earlier in the CFS group (41.7 years vs. 46.1 years, respectively, p=0.11). Among menopausal women, 76% of the CFS group reported hysterectomy vs. 54.6% of controls (p=0.09), and 56% of women with CFS reported oophorectomy vs. 34.3% of controls (p=0.11). Conclusions: The higher prevalence of gynecological conditions and gynecological surgeries in women with CFS highlights the importance of evaluating gynecological health in these patients and the need for more research to clarify the chronologic and the pathophysiological relationships between these conditions and CFS.