Boneva, Roumiana S, Lin, Jin-Mann S, Unger, Elizabeth R · Menopause (New York, N.Y.) · 2015 · DOI
This study looked at whether gynecological conditions—like irregular periods, endometriosis, and early menopause—are more common in women with ME/CFS compared to healthy women. Researchers found that women with ME/CFS reported significantly more gynecological problems and surgeries, including hysterectomies (removal of the uterus) performed at younger ages. The findings suggest that gynecological issues may be connected to ME/CFS, though more research is needed to understand exactly how.
This study reveals a previously underexamined connection between common gynecological conditions and ME/CFS, suggesting that clinicians should screen for gynecologic problems in women with ME/CFS and vice versa. The temporal relationship (surgeries preceding CFS onset in many cases) raises important questions about whether these conditions or their treatments may trigger or perpetuate ME/CFS in some women, potentially opening new avenues for understanding disease mechanisms.
This study demonstrates association, not causation—it does not prove that gynecologic conditions cause ME/CFS. The cross-sectional design and reliance on patient recall of past gynecologic events introduce potential bias. The study cannot determine whether shared underlying mechanisms (such as immune dysfunction or hormonal dysregulation) explain both gynecologic problems and ME/CFS, nor can it rule out reverse causality or confounding variables.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Boneva, Roumiana S, Lin, Jin-Mann S, & Unger, Elizabeth R (2015). Early menopause and other gynecologic risk indicators for chronic fatigue syndrome in women.. Menopause (New York, N.Y.). https://doi.org/10.1097/GME.0000000000000411
BibTeX
@article{mecfsatlas-boneva-2015-early-menopause,
author = {Boneva, Roumiana S and Lin, Jin-Mann S and Unger, Elizabeth R},
title = {Early menopause and other gynecologic risk indicators for chronic fatigue syndrome in women.},
journal = {Menopause (New York, N.Y.)},
year = {2015},
doi = {10.1097/GME.0000000000000411},
note = {PubMed: 25647777},
url = {https://www.mecfsatlas.com/evidence/boneva-2015-early-menopause},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-27. https://www.mecfsatlas.com/evidence/boneva-2015-early-menopause
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