Fatigue from the viewpoint of patients with endometriosis

How bothersome is your endometriosis-related fatigue?

Key Points

Highlights:

• The decrease in pain and heavy bleeding were associated with decreased fatigue.

Importance:

• Fatigue can be handled if pain and heavy bleeding are treated.

What's done here:

• Individual interviews with 22 adult females reporting moderate to severe endometriosis-related pain was carried out to better understand endometriosis-related fatigue and its effects on patients.

Key Results:

• Fatigue was reported by all endometriosis patients.
• Most of the participants considered endometriosis-related fatigue to be “quite bothersome”.
• Endometriosis-related fatigue was depicted as feeling “exhausted,” “drained,” “tired,” “lethargic,” “worn out,” and/or “weak” by all patients.
• The participants experienced the worst severity of fatigue before or during the first few days of their period.
• Endometriosis-related fatigue most commonly influenced day-to-day activities, social activities, physical activities, mood and emotions, relationships with family or partner, and work or school.

Limitations:

• The data of this study is subjective and is not confirmed in the participants’ medical records.
• The findings of this study may not be generalized to a broader population or different cultures due to the small sample size, the similar geographic location of both study sites, and the restriction of eligibility to only women with moderate to severe endometriosis-related pain.

Lay Summary

Fatigue, feeling spoonie, is documented as a significant symptom of endometriosis in many studies. Researchers from three different institutions dealing with reproductive health conducted individual interviews with patients reporting moderate to severe endometriosis-related pain to better understand endometriosis-related fatigue and its effect on patients.

The study sample included 22 endometriosis patients who had a mean age of 38.6 years (range, 27-48 years). The research team found that symptoms reported by endometriosis patients were fatigue (100%), pain with periods (86.4%), heavy bleeding (77.3%), nonmenstrual pelvic pain (50.0%), back pain and leg pain (40.9%), headaches/migraines (40.9%), cramping throughout the month (36.4%), gastrointestinal disturbances (constipation, diarrhea, pain with bowel movements) (36.4%), nausea (27.3%), bloating (22.7%), painful intercourse (18.2%), infertility (18.2%), and ovulation-related pain (9.1%). It was also seen that nearly two-thirds of participants were having periods monthly, and the remaining 8 participants reported having irregular periods.

How bothersome their endometriosis-related fatigue was rated by the participants using a five-point scale ranging from “not at all bothersome” to “extremely bothersome. Endometriosis-related fatigue was considered to be “quite bothersome” by most of the participants. None of the participants declared that it was “not at all bothersome.

All patients described their endometriosis-related fatigue as feeling “exhausted,” “drained,” “tired,” “lethargic,” “worn out,” and/or “weak.” The worst severity of fatigue that the participants' experience was seen before or during the first few days of their period.

The authors observed that endometriosis-related fatigue most commonly influence day-to-day activities, social activities, physical activities, mood and emotions, relationships with family or partner, and work or school.

In the current study, decreases in pain and heavy bleeding were reported to be associated with decreased fatigue. Hence, DiBenedetti et al, suggested that fatigue can be treated if pain and heavy bleeding are treated. Future studies are needed to measure any changes in fatigue that may be associated with treatment for endometriosis, they added.

This study has recently been published in the Journal of Patient-Reported Outcomes.

Research Source: https://www.ncbi.nlm.nih.gov/pubmed/32377820