Endometriosis and Fibromyalgia

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Endometriosis is a health problem that is relatively common among women. It is a condition that occurs when the lining of the uterus, which is known as the endometrium, grows outside of the uterus on to other organs and structures within the abdomen. The most frequently affected sites include the ovaries, fallopian tubes, connective tissue that holds the uterus in place, outer surface of the uterus, and the lining of the pelvic cavity. However, endometriosis can also affect the vagina, cervix, bowel, bladder, or rectum. In extremely rare cases, it can spread as far as the lungs, brain, and on to the skin.

Although some women with endometriosis will not experience any pain, in general, endometriosis is a very painful condition. Pain is most commonly felt in the lower pelvis or lower back, particularly during menstruation. Common symptoms include severe menstrual cramps that worsen over time, chronic lower back and pelvic pain, pain during or following intercourse, intestinal pain, pain during bowel movements or urination (especially during menstrual periods), infertility, and fatigue. Considerable research has linked endometriosis to a number of other conditions, including autoimmune diseases such as hypothyroidism and lupus, chronic fatigue syndrome, fibromyalgia, increased susceptibility to infections, heart valve disease, frequent yeast infections, and certain cancers.

Due to the pelvic pain associated with endometriosis, it can often be mistaken for a different disease, such as pelvic inflammatory disease, irritable bowel syndrome, or other gastrointestinal disorders. Pelvic exams and ultrasounds are useful to help narrow the focus of diagnosis, however the only way to definitively diagnose endometriosis is through the use of laparoscopy. Laparoscopy is a minor surgical procedure in which a thin tube with a light at the end is placed into a small incision on the abdomen. This light allows doctors to see the growths produced by endometriosis. On occasion, a diagnosis can be made upon visual confirmation of these growths; other times, a small tissue sample must be obtained and examined under a microscope.

Research on Endometriosis and Fibromyalgia

Endometriosis and fibromyalgia share a number of common features. In addition to the widespread pain associated with both conditions, both tend to affect women of reproductive age, have a tendency to run in families, and cause affected individuals to modify their daily behaviors to accommodate their symptoms and resulting limitations. Furthermore, definitive diagnosis of fibromyalgia and endometriosis is often delayed, and is frequently obtained only at the exclusion of other similar conditions.

In addition to their overlapping symptomotology, fibromyalgia and endometriosis can also co-occur in the same individual. A 1998 survey sought to determine the prevalence of various autoimmune disorders, chronic pain, fatigue, and other conditions among patient members of the Endometriosis Association. Of the 10,000 US and Canadian members who initially received the survey, responses from 3,680 women with surgically-diagnosed endometriosis were eligible for analysis. The researchers found that nearly 20% of the women with endometriosis had one or more co-existing diseases. Of these women, 31% had a diagnosis of fibromyalgia and/or chronic fatigue syndrome. Furthermore, the survey showed that fibromyalgia was twice as common among women with endometriosis than among women in the general US population (5.9% versus 3.4%, respectively) (Sinaii et al, 2002). Based on the findings of this study, the authors urge physicians to consider the coexistence of both conditions, and others, when evaluating patients who present with pelvic symptoms.

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References

Sinaii N, Cleary SD, Ballweg ML, Nieman LK, Stratton P. High rates of autoimmune and endocrine disorders, fibromyalgia, chronic fatigue syndrome and atopic diseases among women with endometriosis: a survey analysis. Hum Reprod. 2002;17(10):2715-2724.

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