Association between endometriosis, fibromyalgia and autoimmune diseases

Women with both endometriosis and fibromyalgia have a higher risk of having autoimmune diseases, anxiety, or depression as well as more hospitalizations, a study reports.

Evidence for an association between endometriosis, fibromyalgia and autoimmune diseases, was published in the American Journal of Reproductive Immunology in January 2019.

Fibromyalgia is a disorder characterized by widespread musculoskeletal chronic pain and many symptoms including painful menstrual cycles.

Endometriosis is a painful condition that affects a woman's reproductive organs.

Autoimmune disease occurs when the immune system attacks healthy organs and tissues within the body. There are over 80 autoimmune diseases. 

AIM

The aim of this study was to investigate the prevalence of and the association between endometriosis, fibromyalgia and autoimmune disease (AID) in a large population.

METHODS

To investigate the prevalence of and the association among endometriosis, fibromyalgia, and autoimmune diseases, a group of researchers did a retrospective analysis of data from the Maccabi Healthcare Services (MHS), a large healthcare plan in Israel.

The analysis included women diagnosed with endometriosis and/or fibromyalgia and a control group of women without either of the conditions.

In total, 781,571 adult women were considered eligible for the study, of whom 6,647 had endometriosis and 25,425 had fibromyalgia. Existence of both conditions was detected in 401 of the cases.

RESULTS

Women with both fibromyalgia and endometriosis had:

• a high prevalence rate of AID compared to women with no diagnosis of endometriosis/fibromyalgia 
• an increased healthcare resource utilization (HCRU)
• an increased history of depression or anxiety
• inflammatory bowel disease (IBD) in 6.2% 
• other autoimmune diseases including systemic lupus erythematosus and Sjögren syndrome.

Interestingly many of the women with both conditions were diagnosed with fibromyalgia before endometriosis. 

The existence of fibromyalgia was significantly higher in women with endometriosis than in the control group.

Women with both conditions had a higher rate of hospitalizations, than the control group, highlighting the negative impact of these disorders on quality of life.

This study shows that the existence of autoimmune diseases is higher in women with endometriosis and fibromyalgia. These findings support the hypothesis that both endometriosis and fibromyalgia have an autoimmune component.

Hopefully these results contribute to developing a more thorough approach to managing the complex needs of these women.

Diagnosing either or both conditions should raise the possibility of the existence of autoimmune diseases. 

CONCLUSION

Co‐occurrence of endometriosis and fibromyalgia is associated with a high burden of autoimmune disease, anxiety/depression, and HCRU.