Hosier, Gregory W, Doiron, R Christopher, Tolls, Victoria et al. · Canadian Urological Association journal = Journal de l'Association des urologues du Canada · 2018 · DOI
This study compared how chronic pelvic pain affects men and women differently. Researchers found that women with pelvic pain had more bladder symptoms, nerve-related symptoms, and were more likely to have other conditions like chronic fatigue syndrome, fibromyalgia, and depression. Men and women with the same diagnosis actually experience quite different patterns of pain and related health problems.
This study is relevant to ME/CFS patients because it documents a 8.5-fold higher prevalence of chronic fatigue syndrome in females with UCPPS and identifies sex-based differences in comorbidity patterns. Understanding how chronic pain conditions co-occur differently in men and women may help explain why ME/CFS presents differently by sex and inform better diagnostic and treatment strategies for overlapping conditions.
This study does not prove that UCPPS causes ME/CFS or that sex hormones directly cause the observed differences—it only shows correlation. The retrospective design means comorbid diagnoses were not systematically confirmed at enrollment, and causality between UCPPS and other systemic conditions remains unclear. Cross-sectional data cannot establish temporal relationships or rule out confounding factors.
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
Hosier, Gregory W, Doiron, R Christopher, Tolls, Victoria, & Nickel, J Curtis (2018). The X-Y factor: Females and males with urological chronic pelvic pain syndrome present distinct clinical phenotypes.. Canadian Urological Association journal = Journal de l'Association des urologues du Canada. https://doi.org/10.5489/cuaj.4798
BibTeX
@article{mecfsatlas-hosier-2018-factor-females,
author = {Hosier, Gregory W and Doiron, R Christopher and Tolls, Victoria and Nickel, J Curtis},
title = {The X-Y factor: Females and males with urological chronic pelvic pain syndrome present distinct clinical phenotypes.},
journal = {Canadian Urological Association journal = Journal de l'Association des urologues du Canada},
year = {2018},
doi = {10.5489/cuaj.4798},
note = {PubMed: 29485033},
url = {https://www.mecfsatlas.com/evidence/hosier-2018-factor-females},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/hosier-2018-factor-females
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