Endometriosis and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Systematic Review and Meta-Analysis
Abstract
Background/Objectives: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and endometriosis are debilitating conditions that share overlapping features of chronic inflammation and immune dysregulation, yet their epidemiological relationship remains poorly characterized. The objective of this study was to investigate the association between ME/CFS and endometriosis, examining shared risk factors, clinical correlates, and epidemiological patterns. Methods: We conducted a systematic review and meta-analysis. Two independent reviewers screened 236 records after duplicate removal, with seventeen studies undergoing full-text review and thirteen meeting inclusion criteria for meta-analysis. Data were extracted using standardized forms and analyzed using random-effects models in R, with heterogeneity assessed using I2 statistics and the risk of bias evaluated using the JBI critical appraisal tool. Results: Our meta-analysis of five studies (n = 2261 participants) revealed that women with endometriosis had 2.79-fold higher odds (95% CI: 2.00–3.89) of developing ME/CFS compared to controls. Similarly, our fixed-effects meta-analysis of two studies assessing the association of ME/CFS and endometriosis yielded a pooled OR of 2.52 (95% CI: 2.45–2.60, p 0.7969) for both meta-analyses. Conclusions: This study demonstrates a significant bidirectional association between endometriosis and ME/CFS, driven by shared mechanisms of immune dysregulation and chronic inflammation. Despite…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 2,261 participants or records.
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