Fibromyalgia and hysterectomy: the impact on health status and health care costs

Santoro, Maya S.; Cronan, Terry A.; Adams, Rebecca N.; Kothari, Dhwani J.

doi:10.1007/s10067-012-2051-z

Cited by 8 publications

(5 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Hysterectomy preceded fibromyalgia diagnosis in 90.7% of cases who had both conditions. 21 Similarly, in our study, hysterectomy and oophorectomy preceded fatigue onset in 71% of women with available data on both. Although associations between hysterectomy and severity of illness have not been studied in women with CFS, in fibromyalgia, women who have had hysterectomy have lower physical function and greater severity of pain, fatigue, stiffness, and depression than those who have not had hysterectomy.…”

Section: Discussionsupporting

confidence: 76%

Early menopause and other gynecologic risk indicators for chronic fatigue syndrome in women

2015

View full text Add to dashboard Cite

Objective This study aims to examine whether gynecologic conditions are associated with chronic fatigue syndrome (CFS). Methods This study includes a subset of 157 women from a population-based case-control study in Georgia, United States, conducted in 2004-2009. Gynecologic history was collected using a self-administered questionnaire. Crude odds ratios (ORs) with 95% CIs and ORs adjusted for body mass index and other covariates, where relevant, were estimated for gynecologic conditions between 84 CFS cases and 73 healthy controls. Results Cases and controls were of similar age. Women with CFS reported significantly more gynecologic conditions and surgical operations than controls: menopause status (61.9% vs 37.0%; OR, 2.37; 95% CI, 1.21-4.66), earlier mean age at menopause onset (37.6 vs 48.6 y; adjusted OR, 1.22; 95% CI, 1.09-1.36), excessive menstrual bleeding (73.8% vs 42.5%; adjusted OR, 3.33; 95% CI, 1.66-6.70), bleeding between periods (48.8% vs 23.3%; adjusted OR, 3.31; 95% CI, 1.60-6.86), endometriosis (29.8% vs 12.3%; adjusted OR, 3.67; 95% CI, 1.53-8.84), use of noncontraceptive hormonal preparations (57.1% vs 26.0%; adjusted OR, 2.95; 95% CI, 1.36-6.38), nonmenstrual pelvic pain (26.2% vs 2.7%; adjusted OR, 11.98; 95% CI, 2.57-55.81), and gynecologic surgical operation (65.5% vs 31.5%; adjusted OR, 3.33; 95% CI, 1.66-6.67), especially hysterectomy (54.8% vs 19.2%; adjusted OR, 3.23; 95% CI, 1.46-7.17). Hysterectomy and oophorectomy occurred at a significantly younger mean age in the CFS group than in controls and occurred before CFS onset in 71% of women with records of date of surgical operation and date of CFS onset. Conclusions Menstrual abnormalities, endometriosis, pelvic pain, hysterectomy, and early/surgical menopause are all associated with CFS. Clinicians should be aware of the association between common gynecologic problems and CFS in women. Further work is warranted to determine whether these conditions contribute to the development and/or perpetuation of CFS in some women.

show abstract

Section: Discussionsupporting

confidence: 76%

Early menopause and other gynecologic risk indicators for chronic fatigue syndrome in women

2015

View full text Add to dashboard Cite

show abstract

“…Additionally, women with FM are more likely to have had a hysterectomy compared with the general population, yet hysterectomy may not improve chronic pelvic pain in women with FM (Pamuk, Donmez, & Cakir, 2009; Santoro, Cronan, Adams, & Kothari, 2012; ter Borg, Gerards-Rociu, Haanen, & Westers, 1999). Similarly patients with chronic pelvic pain compared with those without recently were found to be at increased risk of not improving or even worsening after undergoing transvaginal mesh revision (Danford, Osborn, Reynolds, Biller, & Dmochowski, 2015).…”

Section: Discussionmentioning

confidence: 99%

“…First, these responses may be a reflection of the relatively high prevalence of pelvic floor disorders in the general population (Nygaard et al, 2008), coupled with the high prevalence of FM in the general population. Another possible explanation is that women with FM are more likely to have had previous hysterectomy compared with the general population (Santoro et al, 2012), which is also associated with higher prevalence and degree of pelvic organ prolapse (Swift, 2000). Retrospective survey data recently identified that the presence of functional somatic syndromes, including FM, was found to be a separate, independent risk factor for hysterectomy in women with bladder pain/interstitial cystitis (Williams & Clauw, 2009).…”

Section: Discussionmentioning

confidence: 99%

Pelvic Floor and Urinary Distress in Women with Fibromyalgia

Jones

Maxwell

Mist

et al. 2015

Pain Management Nursing

View full text Add to dashboard Cite

Fibromyalgia (FM) patients were recently found to have more symptom burden from bothersome pelvic pain syndromes that women seeking care for pelvic floor disease at a urogynecology clinic. We sought to further characterize pelvic floor symptoms in a larger sample of FM patients using of validated questionnaires. Female listserv members of the Fibromyalgia Information Foundation completed an online survey of three validated questionnaires: the Pelvic Floor Distress Inventory 20 , the Pelvic Pain, Urgency and Frequency Questionnaire (PUF), and the Revised Fibromyalgia Impact Questionnaire (FIQR). Scores were characterized using descriptive statistics. Patients (n = 204 with complete data on 177) were on average 52.3 ± 11.4 years with a mean parity of 2.5 ± 1.9. FM severity based on FIQR score (57.2 ± 14.9) positively correlated with PFDI-20 total 159.08 ± 55.2 (r = .34, p <.001) and PUF total 16.54 ± 7 (r = .36, p <.001). Women with FM report significantly bothersome pelvic floor and urinary symptoms. Fibromyalgia management should include evaluation and treatment of pelvic floor disorders recognizing that pelvic distress and urinary symptoms are associated with more severe FM symptoms. Validated questionnaires, like the ones used in this study, are easily incorporated into clinical practice.Fibromyalgia (FM) is a common, debilitating disorder of widespread pain affecting an estimated 5 million persons in the United States (Lawrence et al., 2008). Similarly, chronic pelvic pain is estimated to affect at least 9 million women (Mathias, Kuppermann, Liberman, Lipschutz, & Steege, 1996), and 4 to 7 million women report bladder pain/ interstitial cystitis symptoms (Berry et al., 2011). Given that these three chronic pain syndromes are highly prevalent, it is not surprising that they often coexist. Indeed, people with FM often report numerous regional pain syndromes, including headaches, temporomandibular disorders, low back/neck pain, myofascial pain, irritable bowel, pelvic pain, and bladder pain (Adams & Denman, 2011;Arnold, Clauw, & McCarberg, 2011;Rodriguez, Afari, & Buchwald, 2009;Williams & Clauw, 2009 Clemens et al., 2014;Adams & Denman, 2011). Pelvic floor disorders negatively influence a woman's activities of daily living, sexual function, bowel and bladder function, and overall quality of life. Despite their high prevalence and negative impact, little known about the relationship between pelvic/bladder symptoms and FM severity. The purpose of this study was to characterize pelvic floor and urinary symptoms in patients with FM. A secondary aim was to describe the strength of the relationship between pelvic floor and urinary symptoms with the total impact of FM. HHS Public Access MATERIALS AND METHODS Design, Participants, and ProceduresThis study was a cross-sectional descriptive survey in women with FM. Five hundred female patients were contacted via e-mail and requested to complete an online "women's health survey" (SurveyMonkey, Inc., Palo Alto, CA Pelvic floor symptoms were measured using the PFDI-...

show abstract

“… 32 In an additional study of female FM patients, not only was there a greater frequency of women who had received a hysterectomy versus those who had not, but 90% of the FM patients with hysterectomies reported receiving the surgery before the onset of FM. 33 Having FM with a previous history of a hysterectomy was associated with a lower general health status. 32 …”

Section: Introductionmentioning

confidence: 97%

Assessing the prevalence of autoimmune, endocrine, gynecologic, and psychiatric comorbidities in an ethnically diverse cohort of female fibromyalgia patients: does the time from hysterectomy provide a clue?

Brooks¹,

Hadi²,

Amber³

et al. 2015

JPR

View full text Add to dashboard Cite

BackgroundThis retrospective chart review investigated differences in the prevalence of medical comorbidity between women with fibromyalgia (FM) (n=219) and a control group women with chronic pain (CP) without FM (n=116). The specific aims were to compare the prevalence of autoimmune, psychiatric, endocrine, gynecologic pathology, the relationship between timing of gynecologic surgery, and pain onset. We additionally sought to compare the number of comorbidities in an ethnically diverse cohort.MethodsThis was a retrospective chart review of patients seen in FM or CP clinics at an academic medical center in 2009–2010.ResultsLogistic regression modeling found that gynecologic, endocrine, and autoimmune diagnoses were independently associated with a diagnosis of FM. Detailed analyses showed that thyroid disease (P<0.01) and gynecologic surgery (P<0.05) were significantly more common in FM. Women with FM were more likely to have multiple autoimmune, endocrine, gynecologic, or psychiatric pathologies. A relationship was observed between the timing of gynecologic surgery and pain onset in FM, with more surgeries observed in the years just prior to pain onset or in the year after pain onset. A similar pattern was not found in the control group.ConclusionThis study demonstrates that autoimmune, endocrine, and gynecologic pathologies occur more commonly in women with FM than in those with CP, which is consistent with findings in less ethnically diverse samples. Moreover, a relationship was found between timing of pain onset and gynecologic surgery. A larger prospective study of the relationship between gynecologic surgery and pain onset in FM is warranted.

show abstract

Fibromyalgia and hysterectomy: the impact on health status and health care costs

Cited by 8 publications

References 30 publications

Early menopause and other gynecologic risk indicators for chronic fatigue syndrome in women

Early menopause and other gynecologic risk indicators for chronic fatigue syndrome in women

Pelvic Floor and Urinary Distress in Women with Fibromyalgia

Assessing the prevalence of autoimmune, endocrine, gynecologic, and psychiatric comorbidities in an ethnically diverse cohort of female fibromyalgia patients: does the time from hysterectomy provide a clue?

Contact Info

Product

Resources

About