Abstract
Objective
The association between demographic factors, menstrual and reproductive characteristics, and clinical profile for women with endometriosis was analyzed in a retrospective case-control study.
Methods
Over a 6-year period, 535 women with endometriosis and 200 infertile women without endometriosis, studied by laparoscopy or laparotomy, were evaluated. Information was then collected in a uniform manner from the patients’ medical records. Statistical methods included χ 2 and Mann–Whitney U test.
Results
The factors associated with an increased risk for endometriosis include lower body weight, alcohol use (χ 2 = 8.8; P < 0.003), early menarche (χ 2 = 5.08; P < 0.024), shorter cycle length (χ 2 = 13.06; P < 0.001), and heavier menstrual cycles. Pelvic pain was present in 79.1% of women with endometriosis, dysmenorrhea in 70.2%, and dyspareunia in 49.5%. These symptoms were statistically significantly higher in comparison with the infertile women without endometriosis (P < 0.001). Moreover, we found that women with endometriosis had fewer prior pregnancies, elective abortions and ectopic pregnancies compared to women seeking care for infertility, who did not have endometriosis. Interestingly, women with endometriosis were significantly more likely to report a family history of cancer compared to women in control group (χ 2 = 78.2; P < 0.001).
Conclusions
Body habitus, personal habits and menstrual characteristics are all strongly associated with the development of endometriosis. There may also be an association between family history of cancer and the development of endometriosis.
Similar content being viewed by others
References
Ballwey ML (1999) The endometriosis sourcebook. The Endometriosis Association, Milwaukee
Candiani GB, Vercellini P, Fedele L, Colombo A, Candiani M (1991) Mild endometriosis and infertility: a critical review of epidemiologic data, diagnostic pitfalls, and classification limits. Obstet Gynecol Surv 46:374–382
Modugno F, Ness RB, Allen GO, Schildkraut JM, Davis FG, Goodman MT (2004) Oral contraceptive use, reproductive history, and risk of epithelial ovarian cancer in women with and without endometriosis. Am J Obstet Gynecol 191:733–740
Olive DL, Schwartz LB (1993) Endometriosis. N Engl J Med 328:1759–1769
Sangi-Haghpeykar H, Poindexter AN III (1995) Epidemiology of endometriosis among parous women. Obstet Gynecol 85:983–992
Stefansson H, Geirsson RT, Steinthorsdottir V, Jonsson H, Manolescu A, Kong A et al (2002) Genetic factors contribute to the risk of developing endometriosis. Hum Reprod 17:555–559
Vigano P, Parazzini F, Somigliana E, Vercellini P (2004) Endometriosis: epidemiology and aetiological factors. Best Pract Res Clin Obstet Gynaecol 18:177–200
Cramer DW, Wilson E, Stillman RJ, Berger MJ, Belisle S, Schiff I et al (1986) The relation of endometriosis to menstrual characteristics, smoking, and exercise. JAMA 255:1904–1908
Hemmings R, Rivard M, Olive DL, Poliquin-Fleury J, Gagne D, Hugo P et al (2004) Evaluation of risk factors associated with endometriosis. Fertil Steril 81:1513–1521
Hornstein MD, Thomas PP, Sober AJ, Wyshak G, Albright NL, Frisch RE (1997) Association between endometriosis, dysplastic naevi and history of melanoma in women of reproductive age. Hum Reprod 12:143–145
Kuohung W, Jones GL, Vitonis AF, Cramer DW, Kennedy SH, Thomas D et al (2002) Characteristics of patients with endometriosis in the United States and the United Kingdom. Fertil Steril 78:767–772
Vercellini P, De Giorgi O, Aimi G, Panazza S, Uglietti A, Crosignani PG (1997) Menstrual characteristics in women with and without endometriosis. Obstet Gynecol 90:264–268
DePriest PD, Banks ER, Powell DE, van Nagell JR Jr, Gallion HH, Puls LE et al (1992) Endometrioid carcinoma of the ovary and endometriosis: the association in postmenopausal women. Gynecol Oncol 47:71–75
Komiyama S, Aoki D, Tominaga E, Susumu N, Udagawa Y, Nozawa S (1999) Prognosis of Japanese patients with ovarian clear cell carcinoma associated with pelvic endometriosis: clinicopathologic evaluation. Gynecol Oncol 72:342–346
Leiserowitz GS, Gumbs JL, Oi R, Dalrymple JL, Smith LH, Ryu J et al (2003) Endometriosis-related malignancies. Int J Gynecol Cancer 13:466–471
Oral E, Ilvan S, Tustas E, Korbeyli B, Bese T, Demirkiran F et al (2003) Prevalence of endometriosis in malignant epithelial ovary tumours. Eur J Obstet Gynecol Reprod Biol 109:97–101
Revised American Fertility Society Classification of Endometriosis (1985) Fertil Steril 43:351–352
Missmer SA, Cramer DW (2003) The epidemiology of endometriosis. Obstet Gynecol Clin North Am 30:1–19
Signorello LB, Harlow BL, Cramer DW, Spiegelman D, Hill JA (1997) Epidemiologic determinants of endometriosis: a hospital-based case-control study. Ann Epidemiol 7:267–741
Moen MH, Schei B (1997) Epidemiology of endometriosis in a Norwegian county. Acta Obstet Gynecol Scand 76:559–562
Cramer DW, Missmer SA (2002) The epidemiology of endometriosis. Ann N Y Acad Sci 955:11–22. discussion 34–36, 396–406
Houston DE (1984) Evidence for the risk of pelvic endometriosis by age, race and socioeconomic status. Epidemiol Rev 6:167–191
Grodstein F, Goldman MB, Cramer DW (1994) Infertility in women and moderate alcohol use. Am J Public Health 84:1429–1432
Reichman ME, Judd JT, Longcope C, Schatzkin A, Clevidence BA, Nair PP et al (1993) Effects of alcohol consumption on plasma and urinary hormone concentrations in premenopausal women. J Natl Cancer Inst 85:722–727
Groll M (1984) Endometriosis and spontaneous abortion. Fertil Steril 41:933–935
Petersohn L (1970) Fertility in patients with ovarian endometriosis before and after treatment. Acta Obstet Gynecol Scand 49:331–333
Devereux WP (1963) Endometriosis: long-term observation, with particular reference to incidence of pregnancy. Obstet Gynecol 22:444–450
Matorras R, Rodriguez F, Gutierrez de Teran G, Pijoan JI, Ramon O, Rodriguez-Escudero FJ (1998) Endometriosis and spontaneous abortion rate: a cohort study in infertile women. Eur J Obstet Gynecol Reprod Biol 77:101–105
Brinton LA, Gridley G, Persson I, Baron J, Bergqvist A (1997) Cancer risk after a hospital discharge diagnosis of endometriosis. Am J Obstet Gynecol 176:572–579
Eskenazi B, Warner ML (1997) Epidemiology of endometriosis. Obstet Gynecol Clin North Am 24:235–258
Vessey MP, Villard-Mackintosh L, Painter R (1993) Epidemiology of endometriosis in women attending family planning clinics. BMJ 306:182–184
Acknowledgments
We thank the staff of the Division of Reproductive Endocrinology and Infertility, who performed these operations.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Matalliotakis, I.M., Cakmak, H., Fragouli, Y.G. et al. Epidemiological characteristics in women with and without endometriosis in the Yale series. Arch Gynecol Obstet 277, 389–393 (2008). https://doi.org/10.1007/s00404-007-0479-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00404-007-0479-1