Epidemiology of endometriosis in women attending family planning clinics
Open accessAbstract
OBJECTIVE: To describe the epidemiology of endometriosis in women attending family planning clinics with special reference to contraceptive methods. DESIGN: Non-randomised cohort study with follow up of subjects for up to 23 years. Disease was measured by first hospital admission rates since endometriosis can be diagnosed with accuracy only at laparotomy or laparoscopy. SETTING: 17 family planning centres in England and Scotland. SUBJECTS: 17,032 married white women aged 25-39 years at entry during 1968-74 who were taking oral contraceptives or using an intrauterine device or diaphragm. About 99% of the women approached agreed to participate and annual loss to follow up was about 0.3%. MAIN OUTCOME MEASURES: Diagnosis of endometriosis, age, parity, and history of contraceptive use. RESULTS: Endometriosis was significantly related to age, peaking at ages 40-44 (chi 2 for heterogeneity = 30.9, p < 0.001). Endometriosis was not linked to duration of taking oral contraceptives. Nevertheless, the risk of endometriosis was low in women currently taking oral contraceptives (relative risk 0.4; 95% confidence interval 0.2 to 0.7), but higher in women who had formerly taken them (1.8; 1.0 to 3.1 in women who had stopped 25-48 months previously) compared with women who had never taken the pill. A similar pattern was seen for use of intrauterine devices (relative risk 0.4 (0.2 to 0.7) in current users and 1.4 (0.4 to 3.2) in users 49-72 months previously compared with never users). No association was found between endometriosis and use of the diaphragm. CONCLUSIONS: Oral contraceptives seem to temporarily suppress endometriosis. Endometriosis may be diagnosed late in women using intrauterine devices as pain and bleeding occur with both.
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Endometriosis causes a significant deterioration in quality of life.
“It causes a significant deterioration in the quality of life [30,31].”
From Endometriosis: Epidemiology, Classification, Pathogenesis, Treatment and Genetics (Review of Literature) (2021) · cites this paper as [30]
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A Long-term follow-up study of women using different methods of contraception— an interim report
Vessey, M., Doll, R., Peto, R., Johnson, B., & Wiggins, P. (1976) · Journal of Biosocial Science · doi:10.1017/s0021932000010890 · Cited by 403 · see citing works
Self-citationPrevalence and genesis of endometriosis
Mahmood, T. A., & Templeton, A. (1991) · Human Reproduction · doi:10.1093/oxfordjournals.humrep.a137377 · Cited by 367 · see citing works
The Relation of Endometriosis to Menstrual Characteristics, Smoking, and Exercise
Cramer, D. W. (1986) · JAMA: The Journal of the American Medical Association · doi:10.1001/jama.1986.03370140102032 · Cited by 367 · see citing works
Endometriosis in women at interval sterilization
Moen, M. H. (1987) · Acta Obstetricia Et Gynecologica Scandinavica · doi:10.3109/00016348709022053 · Cited by 88 · see citing works
(1976) · Annals of Internal Medicine · doi:10.7326/0003-4819-84-6-764_1 · Cited by 74 · see citing works
Contraception: a risk factor for endometriosis.
Kirshon, B., & Poindexter, A. N. (1988) · PubMed · Cited by 43 · see citing works
Obermeyer, C. M., Armenian, H. K., & Azoury, R. S. (1986) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a114452 · Cited by 32 · see citing works
Cyclic use of Combination Oral Contraceptives and the Severity of Endometriosis
Buttram, V. C. (1979) · Fertility and Sterility · doi:10.1016/s0015-0282(16)43887-2 · Cited by 17 · see citing works
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Eskenazi, B., & Warner, M. L. (1997) · Obstetrics and Gynecology Clinics of North America · doi:10.1016/s0889-8545(05)70302-8 · Cited by 1,617 · see citing works
Simoens, S., Dunselman, G., Dirksen, C., Hummelshoj, L., Bokor, A., Brandes, I., Brodszky, V., Canis, M., Colombo, G. L., DeLeire, T., et al. (2012) · Human Reproduction · doi:10.1093/humrep/des073 · Cited by 1,070 · see citing works
Risk for and consequences of endometriosis: A critical epidemiologic review
Shafrir, A. L., Farland, L. V., Shah, D. K., Harris, H. R., Kvaskoff, M., Zondervan, K., & Missmer, S. A. (2018) · Best Practice & Research Clinical Obstetrics & Gynaecology · doi:10.1016/j.bpobgyn.2018.06.001 · Cited by 823 · see citing works
Endometriosis: epidemiology and aetiological factors
Viganò, P., Parazzini, F., Somigliana, E., & Vercellini, P. (2004) · Best Practice & Research Clinical Obstetrics & Gynaecology · doi:10.1016/j.bpobgyn.2004.01.007 · Cited by 718 · see citing works
Missmer, S. A. (2004) · American Journal of Epidemiology · doi:10.1093/aje/kwh275 · Cited by 616 · see citing works
Smolarz, B., Szyłło, K., & Romanowicz, H. (2021) · International Journal of Molecular Sciences · doi:10.3390/ijms221910554 · Cited by 560 · see citing works
The Epidemiology of Endometriosis
CRAMER, D. W., & MISSMER, S. A. (2002) · Annals of the New York Academy of Sciences · doi:10.1111/j.1749-6632.2002.tb02761.x · Cited by 539 · see citing works
<i>Endometriosis and Infertility</i>: <i>Epidemiology and Evidence‐based Treatments</i>
Ozkan, S., Murk, W., & Arici, A. (2008) · Annals of the New York Academy of Sciences · doi:10.1196/annals.1434.007 · Cited by 347 · see citing works
What makes a good case–control study?
Zondervan, K. T., Cardon, L. R., & Kennedy, S. H. (2002) · Human Reproduction · doi:10.1093/humrep/17.6.1415 · Cited by 271 · see citing works
Aromatase: a key molecule in the pathophysiology of endometriosis and a therapeutic target
Zeitoun, K. M., & Bulun, S. E. (1999) · Fertility and Sterility · doi:10.1016/s0015-0282(99)00393-3 · Cited by 256 · see citing works
Reproductive History and Endometriosis Among Premenopausal Women
Missmer, S. A., Hankinson, S. E., Spiegelman, D., Barbieri, R. L., Malspeis, S., Willett, W. C., & Hunter, D. J. (2004) · Obstetrics & Gynecology · doi:10.1097/01.aog.0000142714.54857.f8 · Cited by 237 · see citing works
Saha, R., Pettersson, H. J., Svedberg, P., Olovsson, M., Bergqvist, A., Marions, L., Tornvall, P., & Kuja-Halkola, R. (2015) · Fertility and Sterility · doi:10.1016/j.fertnstert.2015.06.035 · Cited by 211 · see citing works
Oral contraceptives for pain associated with endometriosis
Brown, J., Crawford, T. J., Datta, S., & Prentice, A. (2018) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd001019.pub3 · Cited by 199 · see citing works
Oral contraceptives and risk of endometriosis: a systematic review and meta-analysis
Vercellini, P., Eskenazi, B., Consonni, D., Somigliana, E., Parazzini, F., Abbiati, A., & Fedele, L. (2011) · Human Reproduction Update · doi:10.1093/humupd/dmq042 · Cited by 176 · see citing works
Evaluation of risk factors associated with endometriosis
Hemmings, R., Rivard, M., Olive, D. L., Poliquin-Fleury, J., Gagné, D., Hugo, P., & Gosselin, D. (2004) · Fertility and Sterility · doi:10.1016/j.fertnstert.2003.10.038 · Cited by 156 · see citing works
Morassutto, C., Monasta, L., Ricci, G., Barbone, F., & Ronfani, L. (2016) · PLOS ONE · doi:10.1371/journal.pone.0154227 · Cited by 157 · see citing works
Aromatase in endometriosis and uterine leiomyomata
Bulun, S. E., Imir, G., Utsunomiya, H., Thung, S., Gurates, B., Tamura, M., & Lin, Z. (2005) · The Journal of Steroid Biochemistry and Molecular Biology · doi:10.1016/j.jsbmb.2005.04.012 · Cited by 154 · see citing works
Chapron, C., Souza, C., Borghese, B., Lafay-Pillet, M.-C., Santulli, P., Bijaoui, G., Goffinet, F., & de Ziegler, D. (2011) · Human Reproduction · doi:10.1093/humrep/der156 · Cited by 148 · see citing works
Estrogen metabolizing enzymes in endometrium and endometriosis
Dassen, H., Punyadeera, C., Kamps, R., Delvoux, B., Van Langendonckt, A., Donnez, J., Husen, B., Thole, H., Dunselman, G., & Groothuis, P. (2007) · Human Reproduction · doi:10.1093/humrep/dem310 · Cited by 141 · see citing works
Catamenial pneumothorax and endometriosis-related pneumothorax: clinical features and risk factors
Rousset-Jablonski, C., Alifano, M., Plu-Bureau, G., Camilleri-Broet, S., Rousset, P., Regnard, J.-F., & Gompel, A. (2011) · Human Reproduction · doi:10.1093/humrep/der189 · Cited by 127 · see citing works
Systematic review of the effects of aromatase inhibitors on pain associated with endometriosis
Patwardhan, S., Nawathe, A., Yates, D., Harrison, G., & Khan, K. (2008) · BJOG: An International Journal of Obstetrics & Gynaecology · doi:10.1111/j.1471-0528.2008.01740.x · Cited by 116 · see citing works
Takamura, M., Koga, K., Osuga, Y., Takemura, Y., Hamasaki, K., Hirota, Y., Yoshino, O., & Taketani, Y. (2009) · Human Reproduction · doi:10.1093/humrep/dep297 · Cited by 98 · see citing works
Nonsteroidal anti-inflammatory drugs for pain in women with endometriosis
Allen, C., Hopewell, S., Prentice, A., & Gregory, D. (2009) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd004753.pub3 · Cited by 75 · see citing works
Upstream stimulatory factor-2 regulates steroidogenic factor-1 expression in endometriosis
Utsunomiya, H., Cheng, Y.-H., Lin, Z., Reierstad, S., Yin, P., Attar, E., Xue, Q., Imir, G., Thung, S., Trukhacheva, E., et al. (2008) · Molecular Endocrinology · doi:10.1210/me.2006-0302 · Cited by 72 · see citing works
Gurates, B., Sebastian, S., Yang, S., Zhou, J., Tamura, M., Fang, Z., Suzuki, T., Sasano, H., & Bulun, S. E. (2002) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2002-020522 · Cited by 70 · see citing works
Thomas, E. J. (1993) · BMJ · doi:10.1136/bmj.306.6871.158 · Cited by 17 · see citing works
Lobo, R. A. (2007) · Comprehensive Gynecology · doi:10.1016/b978-0-323-02951-3.50022-4 · Cited by 4 · see citing works
- Authors
- Vessey, M. P., Villard-Mackintosh, L., & Painter, R.
- Affiliations
- John Radcliffe Hospital (GB)
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 1993-01-16
- Volume
- 306
- Issue
- 6871
- Pages
- 182-184
- ISSN
- 0007-1447 (ISSN-L)
- 0959-8138
- 1468-5833
- OpenAlex
- W1970997691
- Cited by
- 217
- References
- 8
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 3 · 2023: 3 · 2022: 3 · 2021: 2 · 2020: 5 · 2019: 5 · 2018: 5 · 2017: 4 · 2016: 8 · 2015: 3 · 2014: 9 · 2013: 8 · 2012: 10
- FWCI
- 6.22
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.bmj.com/company/legal-information/terms-conditions/legal-information/tdm-licencepolicy (tdm)
- Locations
- BMJ (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Medical Research Council
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ectopic Pregnancy Diagnosis and Management
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
- Keywords
- endometriosis, epidemiology, oral contraceptives, intrauterine devices, diaphragm, contraceptive use, parity, age, family planning clinics, hospitalization, long-term follow-up
- MeSH terms
- Adult, Age Factors, Contraceptive Devices, Female, Contraceptives, Oral, Endometriosis, England, Family Planning Services, Female, Humans, Parity, Pelvic Neoplasms, Risk Factors, Time Factors, Cohort Studies
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