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Reproductive correlates of Chronic Fatigue Syndrome (CFS)

  [ 26 votes ]   [ Discuss This Article ]
By Harlow BL, Signorello LB, Hall JE, Dailey C, Komaroff AL • • September 28, 1998

A case-control study was conducted to determine whether
menstrual and gynecologic abnormalities precede the onset of
chronic fatigue syndrome (CFS) in women with this disorder to
a greater extent than that observed among healthy controls. We
identified 150 women who met the 1988 Centers for Disease
Control criteria for CFS from the Brigham and Women's Hospital
Cooperative CFS Research Center. A comparison group of 149
women being seen for nongynecologic conditions were selected
from the waiting area of the Brigham and Women's Hospital
Internal Medicine outpatient department. Women with and
without CFS completed self- administered questionnaires on
menstrual, reproductive, and medical history.

Women with CFS reported increased gynecologic complications
and a lower incidence of premenstrual symptomatology. After
adjustment for age, a somewhat greater number of cases compared
with controls self- reported irregular cycles, periods of amenorrhea,
and sporadic bleeding between menstrual periods. Factors
suggestive of abnormal ovarian function--such as a history of
polycystic ovarian syndrome, hirsutism, and ovarian
cysts--were reported more often in CFS cases compared with

Frequent anovulatory cycles due to ovarian hyperandrogenism (PCOS)
or hyperprolactinemia may increase risk for CFS through loss of the
potential immunomodulatory effects of progesterone in the presence
of continued estrogen production. We hypothesize that frequent anovulatory
cycles due to PCOS and/or hyperprolactinemia may explain the
increased reporting of gynecologic complications and the lower
reported premenstrual symptomatology observed in women with

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