P–306 Premenopausal women with a diagnosis of endometriosis have a significantly higher prevalence of a diagnosis or symptoms suggestive of restless leg syndrome; prospective cross-sectional study
Authors: Tempest N , Boyers M , Carter A , Lane S , Hapangama D 
Published: August 2021

Abstract

Study question
Are women who report a previous surgical diagnosis of endometriosis more likely to have a diagnosis or symptoms suggestive of restless leg syndrome (RLS)? Summary answer: Women who reported a prior surgical diagnosis of endometriosis, have a significantly higher prevalence of prior formal diagnosis of RLS or symptoms suggestive of RLS.

What is known already
Endometriosis and 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) oestrogen driven gynaecological condition, and the prevalence of RLS in women with symptoms or a diagnosis of endometriosis is unknown.

Study design, size, duration
This was a prospective, cross-sectional, observational self-completed questionnaire study. Questionnaires were distributed to 650 women under 50 years of age attending the gynaecology out patient’s department at the Liverpool Women’s hospital from October 2017 to January 2018.

Participants/materials, setting, methods
584 women returned the voluntary, anonymous questionnaires, which assessed RLS-associated (The International Restless Leg Syndrome Study Group rating scale) and endometriosis-associated (modified-British Society of Gynaecological Endoscopists pelvic pain questionnaire) symptoms. The final dataset included 465 completed questionnaires.

Main results and the role of chance
The overall response rate for this study was high (90%, 584/650). Women 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. Women with either a formal diagnosis or symptoms associated with endometriosis 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).

Limitations, reasons for caution
The anonymous, voluntary self-completed questionnaire findings were not confirmed directly using medical records. However, our questionnaire that was piloted for acceptability prior to the study, allowed collation of information directly from women, regarding their clinically relevant symptoms that are important in diagnosing RLS.
Wider implications of the findings: This is the first study highlighting an association between the symptoms relevant to these two chronic conditions, which may help in facilitating the discovery of novel therapeutic targets relevant to both. The simultaneous treatment of these conditions could potentially lead to improvement in overall quality of life for these women.

Trial registration number
NA