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Reproductive correlates of chronic fatigue syndrome

  • BernardL Harlow
    Correspondence
    Requests for reprints should be addressed to Bernard L. Harlow, PhD, Obstetrics and Gynecology Epidemiology Center, Brigham and Women’s Hospital, 221 Longwood Avenue, BLI-3, Boston, Massachusetts 02115
    Affiliations
    Obstetrics and Gynecology Epidemiology Center, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts USA

    Reproductive Endocrine Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts USA

    Department of General Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
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  • LisaB Signorello
    Affiliations
    Obstetrics and Gynecology Epidemiology Center, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts USA

    Reproductive Endocrine Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts USA

    Department of General Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
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  • JanetE Hall
    Affiliations
    Obstetrics and Gynecology Epidemiology Center, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts USA

    Reproductive Endocrine Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts USA

    Department of General Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
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  • Christine Dailey
    Affiliations
    Obstetrics and Gynecology Epidemiology Center, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts USA

    Reproductive Endocrine Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts USA

    Department of General Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
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  • AnthonyL Komaroff
    Affiliations
    Obstetrics and Gynecology Epidemiology Center, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts USA

    Reproductive Endocrine Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts USA

    Department of General Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
    Search for articles by this author

      Abstract

      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 controls. 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 CFS.
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