Boneva, Roumiana S, Lin, Jin-Mann S, Wieser, Friedrich et al. · Frontiers in pediatrics · 2019 · DOI
This study looked at 36 women with ME/CFS to see how many also had endometriosis (a painful condition where tissue grows outside the uterus) and whether it affected their health differently. More than one-third of the women with ME/CFS had endometriosis, and those women reported more ME/CFS symptoms, pelvic pain, and earlier menopause than women with ME/CFS alone. However, endometriosis did not seem to worsen their overall fatigue or functioning.
Many women with ME/CFS have endometriosis, yet this comorbidity is understudied. This research quantifies the overlap and identifies specific symptom burdens associated with having both conditions, which can improve clinical recognition and patient counseling. Understanding which biological pathways are—or are not—shared between these conditions could inform targeted treatments.
This study does not establish whether endometriosis causes or contributes to ME/CFS development, nor whether treating endometriosis would improve ME/CFS outcomes. The small sample size (36 women, mean age ~51 years) and cross-sectional design mean findings may not generalize to younger women or different populations. Association does not imply causation, and unmeasured confounders could explain the observed patterns.
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, Wieser, Friedrich, Nater, Urs M, Ditzen, Beate, Taylor, Robert N, et al. (2019). Endometriosis as a Comorbid Condition in Chronic Fatigue Syndrome (CFS): Secondary Analysis of Data From a CFS Case-Control Study.. Frontiers in pediatrics. https://doi.org/10.3389/fped.2019.00195
BibTeX
@article{mecfsatlas-boneva-2019-endometriosis-comorbid,
author = {Boneva, Roumiana S and Lin, Jin-Mann S and Wieser, Friedrich and Nater, Urs M and Ditzen, Beate and Taylor, Robert N and Unger, Elizabeth R},
title = {Endometriosis as a Comorbid Condition in Chronic Fatigue Syndrome (CFS): Secondary Analysis of Data From a CFS Case-Control Study.},
journal = {Frontiers in pediatrics},
year = {2019},
doi = {10.3389/fped.2019.00195},
note = {PubMed: 31179251},
url = {https://www.mecfsatlas.com/evidence/boneva-2019-endometriosis-comorbid},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/boneva-2019-endometriosis-comorbid
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