Häuser, Winfried · Schmerz (Berlin, Germany) · 2021 · DOI
This review examines how endometriosis (a painful condition affecting the reproductive system) often occurs alongside other chronic pain conditions like fibromyalgia, ME/CFS, migraines, and others. The authors explain that these conditions share common underlying causes—such as childhood stress or trauma—and similar ways the nervous system processes pain signals. They recommend that doctors screen endometriosis patients for these overlapping conditions and use medications like amitriptyline or duloxetine combined with physical therapy and psychological support, rather than repeated surgeries.
ME/CFS is explicitly recognized as a chronic overlapping pain condition in this framework, linking it mechanistically to endometriosis and other chronic pain syndromes through shared pathophysiology. This legitimizes the concept that ME/CFS patients often have multiple concurrent conditions and should be evaluated and treated using a coordinated, multimodal approach rather than condition-specific interventions alone. Understanding these overlaps may improve diagnostic recognition and treatment outcomes for ME/CFS patients.
This review does not prove causality between endometriosis and ME/CFS or establish that one condition causes the other; it identifies epidemiological clustering and shared mechanisms. The review does not present novel empirical data or quantify prevalence rates of COPC co-occurrence. It does not establish which pathophysiological mechanisms are primary versus secondary across different patient subgroups.
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
Häuser, Winfried (2021). [Endometriosis and chronic overlapping pain conditions].. Schmerz (Berlin, Germany). https://doi.org/10.1007/s00482-021-00535-8
BibTeX
@article{mecfsatlas-huser-2021-endometriosis-chronic,
author = {Häuser, Winfried},
title = {[Endometriosis and chronic overlapping pain conditions].},
journal = {Schmerz (Berlin, Germany)},
year = {2021},
doi = {10.1007/s00482-021-00535-8},
note = {PubMed: 33576864},
url = {https://www.mecfsatlas.com/evidence/huser-2021-endometriosis-chronic},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-27. https://www.mecfsatlas.com/evidence/huser-2021-endometriosis-chronic
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