Hypothesis [ME/CFS] and Comorbidities: Linked by Vascular Pathomechanisms and Vasoactive Mediators? 2023, Wirth and Löhn

Wirth and Lohn
Abstract
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is often associated with various other syndromes or conditions including mast cell activation (MCA), dysmenorrhea and endometriosis, postural tachycardia (POTS) and small fiber neuropathy (SFN). The causes of these syndromes and the reason for their frequent association are not yet fully understood. We previously published a comprehensive hypothesis of the ME/CFS pathophysiology that explains the majority of symptoms, findings and chronicity of the disease. We wondered whether some of the identified key pathomechanisms in ME/CFS are also operative in MCA, endometriosis and dysmenorrhea, POTS, decreased cerebral blood flow and SFN, and possibly may provide clues on their causes and frequent co-occurrence. Our analysis indeed provides strong arguments in favor of this assumption, and we conclude that the main pathomechanisms responsible for this association are excessive generation and spillover into the systemic circulation of inflammatory and vasoactive tissue mediators, dysfunctional ß2AdR, and the mutual triggering of symptomatology and disease initiation. Overall, vascular dysfunction appears to be a strong common denominator in these linkages.

https://www.mdpi.com/1648-9144/59/5/978

 

Post moved from duplicate thread

To associate dysmenorrhea and endometriosis at the same level as POTs is a new one for me. What about those without a uterus? (Men and women)

 

Interesting side-note, though a little tangential to your question: people without a uterus - but that previously had one - can have endometriosis. This could be due to residual endometriosis lesions or newly recurrent disease, especially affecting bowel. Less common post oophorectomy, but has been reported de novo post menopause (although HRT may have contributed in eg this case).

Furthermore, you can even be XX female, born without a normal uterus and still get endometriosis. See Clinical Features and Management of Endometriosis among Patients with MRKH and Functional Uterine Remnants (2021).

A case report: Endometriosis in a Patient with Mayer-Rokitansky-Küster-Hauser Syndrome and Complete Uterine Agenesis: Evidence to Support the Theory of Coelomic Metaplasia (2010) —

Possible that that small band of Müllerian tissue had endometrial cells or their primitive precursors. In their discussion, the authors commented —

Recent publication: Endometriosis in Patients with Mayer-Rokitansky-Küster-Hauser-Syndrome—Histological Evaluation of Uterus Remnants and Peritoneal Lesions and Comparison to Samples from Endometriosis Patients without Mullerian Anomaly (2022, Journal of Clinical Medicine)