Fatigue Management Contributes to Effective Endometriosis Care

Investigators aimed to determine the prevalence of fatigue in women diagnosed with endometriosis.

Addressing fatigue may improve quality of life in women with endometriosis and should become a routine part of medical care, according to new findings published in Human Reproduction.

Chronic fatigue has been frequently observed in endometriosis, but large studies evaluating symptoms related to endometriosis have not systematically addressed fatigue. In the current study, researchers investigated the prevalence of fatigue in women diagnosed with endometriosis as compared with a control group. The cohort comprised 560 women with endometriosis and 560 controls (ClinicalTrials.gov Identifier: NCT02511626).

The median time since first diagnosis of endometriosis was 2.6 years, and the time since first diagnosis in participants who experienced frequent fatigue did not significantly differ from women who reported being fatigued only occasionally or rarely (P =.13). Half of the women with endometriosis reported experiencing fatigue (50.7%) vs less than one-quarter (22.4%) of controls (P <.001). Fatigue in women with endometriosis was associated with insomnia (odds ratio [OR] 7.31; CI, 4.62-11.56; P <.001), depression (OR 4.45; CI, 2.76-7.19; P <.001), pain (OR 2.22; CI, 1.52-3.23; P <.001), and occupational stress (OR 1.45; CI, 1.02-2.07; P=.037). The association between endometriosis and frequent fatigue remained significant even after controlling for confounders including the effects of pain, insomnia, occupational stress, depression, body mass index, and being a mother.

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The investigators wrote, “[o]ur results show that endometriosis-related fatigue is a frequent symptom which should be addressed in medical care.” In addition to the “standard treatment of endometriosis, it would be beneficial to reduce insomnia, pain, depression, and occupational stress in order to better manage fatigue,” concluded the authors.


Ramin-Wright A, Kohl Schwartz AS, Geraedts K, et al. Fatigue – a symptom in endometriosis [published online June 26, 2018]. Hum Reprod. doi:10.1093/humrep/dey115