Abstract

BackgroundEndometriosis and restless leg syndrome (RLS) are both chronic conditions that can negatively affect a woman’s quality of life. A higher prevalence of RLS is seen in women and particularly in those who are pregnant, suggesting a possible ovarian hormonal influence. Endometriosis is a common (affecting 1 in 10 women) estrogen driven gynecological condition, and the prevalence of RLS in women with symptoms or a diagnosis of endometriosis is unknown.MethodsA prospective, cross-sectional, observational self-completed questionnaire study was distributed to 650 pre-menopausal women attending the gynecological department at Liverpool Women`s Hospital over a period of 4 months. 584 questionnaires were returned and 465 completed questionnaires were included in the final dataset. Data on RLS-associated (The International Restless Leg Syndrome Study Group rating scale) and endometriosis-associated (modified-British Society of Gynaecological Endoscopists pelvic pain questionnaire) symptoms were collected.ResultsWomen who reported a prior surgical diagnosis of endometriosis had a greater risk of having a prior formal diagnosis of RLS (OR 4.82, 95% CI 1.66,14.02) and suffering RLS symptoms (OR 2.13, 95% CI 1.34-3.39) compared with those without a diagnosis. When women with either a formal surgical diagnosis or symptoms associated with endometriosis were grouped together, they also have a significantly increased risk of having either a formal diagnosis or symptoms suggestive of RLS (OR 2.49, 95% CI 1.30, 3.64). In women suffering with endometriosis-associated symptoms, the cumulative endometriosis-associated symptom scores demonstrated a modest positive correlation with RLS severity scores (r=0.42 95% CI 0.25 to 0.57).ConclusionsThis is the first study highlighting an association between the symptoms relevant to the two chronic conditions RLS and endometriosis, showing that women with a reported prior surgical diagnosis or symptoms suggestive of endometriosis have a significantly higher prevalence of a prior formal diagnosis or symptoms suggestive of RLS. This data will help in facilitating the discovery of novel therapeutic targets relevant to both conditions. The simultaneous treatment of these conditions could potentially lead to improvement in the overall quality of life for these women.

Highlights

  • Endometriosis is a common, chronic, estrogen driven condition, occurring almost exclusively in women of reproductive age

  • Current literature further suggests that women with endometriosis have an increased prevalence of chronic pain syndromes including irritable bowel syndrome (IBS), fibromyalgia, painful bladder syndrome/interstitial cystitis and vulvodynia, which will add to their symptom burden [7,8,9,10,11,12,13]

  • Only 99 (21.3%) out of those, self-reported receiving a formal surgical diagnosis of endometriosis. This gives a rate of formal-surgical diagnosis of endometriosis to be 29.6% (99/334) of the women suffering with endometriosis associated symptoms

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Summary

Introduction

Endometriosis is a common, chronic, estrogen driven condition, occurring almost exclusively in women of reproductive age. It is defined as the growth of endometrium-like tissue, beyond the usual place, the uterine cavity [1]. The prevalence among women of reproductive age is reported to be 10% while 25-50% of infertile women are reported to have a surgical diagnosis of endometriosis at laparoscopy [2, 3]. Endometriosis is a common (affecting 1 in 10 women) estrogen driven gynecological condition, and the prevalence of RLS in women with symptoms or a diagnosis of endometriosis is unknown

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