Fourquet, Jessica, Sinaii, Ninet, Stratton, Pamela et al. · Journal of endometriosis and pelvic pain disorders · 2015 · DOI
This study compared women with endometriosis in the USA and Puerto Rico to see if their symptoms and health conditions differed. Researchers found that while both groups experienced similar types of pain and fertility problems, women in the USA reported more severe pain and more often had other chronic conditions like chronic fatigue syndrome and fibromyalgia. Women in Puerto Rico more frequently reported miscarriages.
This study is relevant to ME/CFS patients because it documents high rates of chronic fatigue syndrome and fibromyalgia as comorbidities in women with endometriosis, particularly in the USA cohort. Understanding how endometriosis co-occurs with other chronic conditions like ME/CFS may help identify shared underlying mechanisms or inform integrated treatment approaches for patients with multiple concurrent illnesses.
This study does not establish causality between endometriosis and comorbid conditions—it only demonstrates that they frequently co-occur. The cross-sectional design cannot determine whether diagnostic delays caused higher symptom burden or whether other factors explain the geographic differences. Self-reported diagnoses without independent clinical verification may introduce accuracy bias.
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
Fourquet, Jessica, Sinaii, Ninet, Stratton, Pamela, Khayel, Fareed, Alvarez-Garriga, Carolina, Bayona, Manuel, et al. (2015). Characteristics of women with endometriosis from the USA and Puerto Rico.. Journal of endometriosis and pelvic pain disorders. https://doi.org/10.5301/je.5000224
BibTeX
@article{mecfsatlas-fourquet-2015-characteristics-women,
author = {Fourquet, Jessica and Sinaii, Ninet and Stratton, Pamela and Khayel, Fareed and Alvarez-Garriga, Carolina and Bayona, Manuel and Ballweg, Mary Lou and Flores, Idhaliz},
title = {Characteristics of women with endometriosis from the USA and Puerto Rico.},
journal = {Journal of endometriosis and pelvic pain disorders},
year = {2015},
doi = {10.5301/je.5000224},
note = {PubMed: 27331050},
url = {https://www.mecfsatlas.com/evidence/fourquet-2015-characteristics-women},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/fourquet-2015-characteristics-women
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