Abstract
Objectives: The endometriosis prevalence in the general population is about 7%-10%. In 30% of women, endometriosis is one of the causes of primary and secondary infertility. There are various risk factors for this disease. The present study aimed to determine the reproductive and menstrual risk factors of endometriosis. Materials and Methods: In this case-control study, 185 women of reproductive age with confirmed endometriosis were compared with 370 women of reproductive age who referred to the same center for other problems in terms of reproductive and menstruation risk factors for endometriosis. The two groups were matched for age. Data were collected using a researcher-made questionnaire based on previous studies. Finally, bivariate analysis was done by the chi-square test, and multivariate analysis was performed by the conditional logistic regression for controlling confounder variables. Results: Based on multivariate logistic regression, early menarche age (P=0.004), no history of pregnancy (P<0.001), no child (P=0.002), no lactation history (P<0.001), high age of the first lactation (P=0.029), short duration of breastfeeding (P=0.015), no regular menstruation (P<0.001), short intervals between menstrual bleedings (P=0.016), prolonged menstruation (P<0.001), dysmenorrhea (P<0.001), dyspareunia (P<0.001), and recurrent vaginitis (P<0.001) had a significant relationship with endometriosis. Conclusions: In general, there was a relationship between some reproductive and menstrual characteristics and endometriosis. Therefore, it seems that these characteristics can predict the occurrence of endometriosis disease.
Highlights
Endometriosis is a gynecologic disease that depends on estrogen (1) and is identified by the existence and implantation of the uterine endometrial stroma and glands somewhere other than their natural location
A systematic review study suggests that oral contraceptive pills decrease the endometriosis risk by stopping ovulation and reducing the amount of bleeding in menstruation
Due to the importance of this disease, its reflection on the fertility of affected women, complications associated with its effects on the life of women of reproductive age, the possible association between endometriosis and some reproductive and menstrual characteristics, and the recommendation of studies for further evaluation, the present study aimed to investigate the reproductive and menstrual risk factors of endometriosis
Summary
Endometriosis is a gynecologic disease that depends on estrogen (1) and is identified by the existence and implantation of the uterine endometrial stroma and glands somewhere other than their natural location (i.e., uterine endometrial cavity). The most common places in the pelvic cavity include ovaries, uterosacral ligament, and Douglas’s pouch (2) Symptoms associated with this disease are menstrual pain, dyspareunia, chronic pelvic pain, irregular menstruation, or infertility (3). A systematic review study indicates that menarche at an early age may slightly increase the risk of endometriosis, which may be higher due to the incorrect classification of the disease in primary studies (12). The incidence rate of endometriosis in women with long-term menstrual bleeding and short intervals between menstruations is high (12,13). A cohort study showed that the risk of endometriosis in nulliparous women with early menarche and short intervals between menstrual periods is high. A systematic review study suggests that oral contraceptive pills decrease the endometriosis risk by stopping ovulation and reducing the amount of bleeding in menstruation. The recommendation to use oral contraceptives for preventing endometriosis has not been approved (16), the use of intrauterine devices
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