Risk Factors for Endometriosis in a German Case–Control Study

Abstract

!Objective: The etiology of endometriosis is still a research field in which few consistent data are available. Large case-control studies or even cohort studies are rare, and most of the published data are conflicting. The aim of the present study was therefore to examine common epidemiological and endometriosis-specific risk factors in a German case-control study. Design: From 2001 to 2010, a pool of 595 laparoscopically confirmed cases and 475 controls were recruited in a hospital-based setting. After matching for age, 298 cases and 300 controls remained in the pool. Age at menarche, menstrual cycle length, duration of menstrual bleeding, number of pregnancies, live births, miscarriages, use of contraceptive pills, body mass index (BMI), and smoking status were analyzed with logistic regression models predicting endometriosis casecontrol status. Results: Menstrual cycle length, duration of menstrual bleeding, number of pregnancies, number of miscarriages, and smoking status, as relevant predictors for endometriosis case-control status, were identified as risk factors for endometriosis. Other factors such as age at menarche, number of live births, ever having used contraceptive pills, and BMI were not predictive. Conclusions: This hospital-based case-control study reproduced most of the familiar risk factors.Comparison of this study with others reveals a wide variety of effect sizes and directions of association with risk factors and may increase the information available about the characteristics of the patient population being treated in the relevant hospital setting.

Factors Affecting Endometriosis in Women of Reproductive Age: The Differences Between the Results of Neural Network and Logistic Regression

“…Based on these studies and other similar studies, pregnancy and live births are protective factors against endometriosis (8,15,17,18). The reason for this phenomenon might be attributable to the fact that menstruation does not occur during pregnancy and some women during lactation, as a result, experience fewer menstrual cycles; so, the likelihood of retrograde menstruation would be reduced in them that may act as a protective factor against endometriosis.…”

Endometriosis: When and How We Treat

“…The most frequently type of endometriosis is endometrioma. Concretely, an endometrioma is considered as the presence of endometrial tissue at the ovarian level organized as a cyst [2]. The incidence of endometrioma is estimated to be 20-45% of patients with endometriosis [3].…”

“…Compared to ovarian endometriosis, very little is known about deeply infiltrating endometriosis. In this form, endometriosis can spread beyond organ borders and infiltrate various structures like sacrouterine ligament, the rectovaginal septum, the fornix of the vagina, the rectosigmoid, the urinary bladder or the ureter or also the small intestine [1][2][3][4][5].…”

“…Definitive diagnosis is made through direct operative visualization by laparoscopy (Figure 1) or laparotomy and histological confirmation [9]. On laparoscopy, endometriosis can appear as yellow-brown discolorations, raised flame-like patches, whitish opacifications or reddish irregularly shaped spots [1,2].…”

“…Endometriosis has four stages or types: stage I, minimal, with small lesions and shallow endometrial implants on the ovary; stage 2, mild, with light lesions and shallow implants on the ovary and the pelvic lining; stage 3, moderate, with deep and more implants on the ovary and pelvic lining; and stage 4, severe, with deep implants on the pelvic lining and ovaries [1][2][3][4][5][6][7][8][9][10][11].…”