University Hospital Zurich, Dept of Reproductive Endocrinology, Frauenklinikstrasse 10, Zurich, Switzerland.
University Women's Hospital, Division of Gynecological Endocrinology and Reproductive Medicines, Effingerstrasse 102, Bern, Switzerland.
Hum Reprod. 2018 Aug 1;33(8):1459-1465. doi: 10.1093/humrep/dey115.
Is fatigue a frequent symptom of endometriosis?
Fatigue is an underestimated symptom of endometriosis as it affects the majority of women with endometriosis, but it is not widely discussed in literature.
Fatigue can be a symptom of endometriosis causing major distress impacting the daily activities and quality of life of women with endometriosis. However, few studies with large sample sizes have investigated fatigue as a symptom of endometriosis.
STUDY DESIGN, SIZE, DURATION: The study was designed as a multi-center matched case-control study. Recruitment took place at hospitals and private practices in Switzerland, Germany and Austria between 2010 and 2016. Data was collected from 1120 women, 560 of them with endometriosis. The women with endometriosis were matched to 560 control women in regard to age ±3 years and ethnic background.
PARTICIPANTS/MATERIALS, SETTING, METHODS: Diagnosis of women with endometriosis had to be surgically and histologically confirmed. Surgical exclusion or absence of any endometriosis-identifying symptoms was required for control subjects. Materials included surgical and histological reports as well as data retrieved from a self-administered questionnaire. This study focused on the symptom fatigue in endometriosis. Relationships of variables were established by regression analysis and associations were quantified as odds ratios.
Frequent fatigue was experienced by a majority of women diagnosed with endometriosis (50.7% versus 22.4% in control women, P < 0.001). Fatigue in endometriosis was associated with insomnia (OR: 7.31, CI: 4.62-11.56, P < 0.001), depression (OR: 4.45, CI: 2.76-7.19, P < 0.001), pain (OR: 2.22, CI: 1.52-3.23, P < 0.001), and occupational stress (OR: 1.45, CI: 1.02-2.07, P = 0.037), but was independent of age, time since first diagnosis and stage of the disease.
LIMITATIONS, REASONS FOR CAUTION: Women with asymptomatic endometriosis cannot be excluded in the control group which would lead to underestimation of our results. The study's design allows no evaluation of causal effects.
As fatigue is experienced by numerous women with endometriosis, it needs to be addressed in the discussion of management and treatment of the disease. In addition to treating endometriosis, it would be beneficial to reduce insomnia, depression, pain and occupational stress in order to better manage fatigue.
STUDY FUNDING/COMPETING INTEREST(S): There was no additional funding received for this study and no conflict of interest.
ClinicalTrials.gov, NCT02511626.
疲劳是子宫内膜异位症的常见症状吗？
疲劳是子宫内膜异位症被低估的症状，因为它影响了大多数患有子宫内膜异位症的女性，但在文献中并未广泛讨论。
疲劳可能是子宫内膜异位症的症状之一，会导致女性出现严重不适，影响她们的日常活动和生活质量。然而，很少有研究调查疲劳作为子宫内膜异位症的症状。
研究设计、规模和持续时间：该研究设计为多中心匹配病例对照研究。招募于 2010 年至 2016 年间在瑞士、德国和奥地利的医院和私人诊所进行。共收集了 1120 名女性的数据，其中 560 名患有子宫内膜异位症。患有子宫内膜异位症的女性与 560 名年龄相差±3 岁且种族背景相同的对照组女性相匹配。
参与者/材料、设置、方法：患有子宫内膜异位症的女性的诊断必须通过手术和组织学确认。对照组的女性需要排除手术或任何子宫内膜异位症的症状。材料包括手术和组织学报告以及从自我管理问卷中检索到的数据。本研究重点关注子宫内膜异位症的症状疲劳。通过回归分析建立变量之间的关系，并将关联量化为优势比。
大多数被诊断患有子宫内膜异位症的女性经历了频繁的疲劳（50.7%对对照组女性的 22.4%，P < 0.001）。子宫内膜异位症中的疲劳与失眠（OR：7.31，CI：4.62-11.56，P < 0.001）、抑郁（OR：4.45，CI：2.76-7.19，P < 0.001）、疼痛（OR：2.22，CI：1.52-3.23，P < 0.001）和职业压力（OR：1.45，CI：1.02-2.07，P = 0.037）相关，但与年龄、首次诊断后的时间和疾病阶段无关。
局限性、谨慎的原因：对照组中不能排除无症状的子宫内膜异位症女性，这将导致我们的结果被低估。该研究的设计不允许评估因果效应。
由于许多患有子宫内膜异位症的女性都经历了疲劳，因此在讨论疾病的管理和治疗时需要考虑到这一点。除了治疗子宫内膜异位症外，减少失眠、抑郁、疼痛和职业压力也将有助于更好地管理疲劳。
研究资金/利益冲突：本研究没有额外的资金支持，也没有利益冲突。
ClinicalTrials.gov，NCT02511626。
