14 September 2008
Journal: Arch Gynecol Obstet. 2008 Sep 12. [Epub ahead of print]
Authors: Veldman J, Van Houdenhove B, Verguts J.
Affiliation: Department of Obstetrics and Gynaecology, University
Hospital Gasthuisberg, Catholic University Leuven, Herestraat 49,
3000, Louvain, Belgium.
NLM Citation: PMID: 18787800
BACKGROUND: Membranous dysmenorrhea is a rare entity involving
expulsion of fragments of endometrium retaining the shape of the
uterus. The condition is often linked to high progesterone levels. An
association with a chronic fatigue syndrome was never described.
CASE: A 44-year-old woman with a chronic fatigue syndrome (CFS),
presented with membranous dysmenorrhea after taking an oral
contraceptive pill containing ethinylestradiol 0.02 mg and
desogestrel 0.15 mg for 3 months in a continuous regimen as treatment
for dysfunctional bleeding. Oral contraception was discontinued and
she resumed normal menstruations. Remarkably, she mentioned complete
disappearance of the CFS since expulsion of the tissue and started
working again.
CONCLUSION: The occurrence of membranous dysmenorrhea with a
dissolving chronic fatigue syndrome is very rare and was never
described before. This case suggests a hormonal dysfunction as a
possible cause of chronic fatigue syndrome. A review of the
literature on membranous dysmenorrhea is presented.