Premenopausal Women With a Diagnosis of Endometriosis Have a Significantly Higher Prevalence of a Diagnosis or Symptoms Suggestive of Restless Leg Syndrome: A Prospective Cross-Sectional Questionnaire Study

Abstract

BackgroundEndometriosis and restless leg syndrome (RLS) are both chronic conditions that can negatively affect a woman’s quality of life. A higher prevalence of RLS is seen in women and particularly in those who are pregnant, suggesting a possible ovarian hormonal influence. Endometriosis is a common (affecting 1 in 10 women) estrogen driven gynecological condition, and the prevalence of RLS in women with symptoms or a diagnosis of endometriosis is unknown.MethodsA prospective, cross-sectional, observational self-completed questionnaire study was distributed to 650 pre-menopausal women attending the gynecological department at Liverpool Women`s Hospital over a period of 4 months. 584 questionnaires were returned and 465 completed questionnaires were included in the final dataset. Data on RLS-associated (The International Restless Leg Syndrome Study Group rating scale) and endometriosis-associated (modified-British Society of Gynaecological Endoscopists pelvic pain questionnaire) symptoms were collected.ResultsWomen who reported a prior surgical diagnosis of endometriosis had a greater risk of having a prior formal diagnosis of RLS (OR 4.82, 95% CI 1.66,14.02) and suffering RLS symptoms (OR 2.13, 95% CI 1.34-3.39) compared with those without a diagnosis. When women with either a formal surgical diagnosis or symptoms associated with endometriosis were grouped together, they also have a significantly increased risk of having either a formal diagnosis or symptoms suggestive of RLS (OR 2.49, 95% CI 1.30, 3.64). In women suffering with endometriosis-associated symptoms, the cumulative endometriosis-associated symptom scores demonstrated a modest positive correlation with RLS severity scores (r=0.42 95% CI 0.25 to 0.57).ConclusionsThis is the first study highlighting an association between the symptoms relevant to the two chronic conditions RLS and endometriosis, showing that women with a reported prior surgical diagnosis or symptoms suggestive of endometriosis have a significantly higher prevalence of a prior formal diagnosis or symptoms suggestive of RLS. This data will help in facilitating the discovery of novel therapeutic targets relevant to both conditions. The simultaneous treatment of these conditions could potentially lead to improvement in the overall quality of life for these women.

The Correlation of Restless Leg Syndrome with Endometriosis: A Cross-Sectional Study

“…The study found a correlation between the IRLSSG rating scale and the rASRAM endometriosis severity score, supporting the research that was conducted by Tempest and col- leagues [12]. The current study showed that there was a correlation between RLS in women with surgically confirmed endometriosis, which showed a significant positive correlation between the severity of endometriosis and the RLS rating scale that is comparable to the study of Sumbodo et al [13].…”

“…For example, iron deficiency anemia is a http://doi.org/10.33091/amj.2024.147487.1618 recognized cause of RLS [18]. In addition, evidence suggests that women with endometriosis have a significantly reduced hemoglobin concentration and average cell volume compared to controls of the same age [12]. In this study, most patients were below 30 years old in cases [19].…”

“…However, only two studies have investigated the association between RLS and endometriosis. The first study by Tempest et al [12] distributed a questionnaire to premenopausal women, collecting data on RLS and endomteriosis associated symptoms. The study did not provide a specific prevalence rate of RLS in women with endometriosis but mentioned that there was a significantly higher prevalence of symptoms of RLS in cases with endometriosis compared to those without endometeriosis.…”

The role of iron in the pathogenesis of endometriosis: a systematic review

“…It is perhaps unsurprising that systemic iron levels may be unaltered in women with endometriosis, but it is unusual for such a fundamental question to remain without a satisfactory answer. Systemic iron deficiency shares many clinical manifestations with endometriosis, including headache, dizziness or light-headedness, and symptoms of restless leg syndrome ( Allen et al , 2013 ; Tempest et al , 2021 ). If iron deficiency is confirmed to be prevalent in symptomatic women with endometriosis, iron replacement is a readily available treatment option to alleviate at least some of the symptoms that negatively affect quality of life.…”