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Epidemiology of endometriosis in women attending family planning clinics.
BMJ. 1993 Jan 16; 306(6871):182-4.BMJ

Abstract

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.

Authors+Show Affiliations

Department of Public Health and Primary Care, Radcliffe Infirmary, Oxford.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

8338516

Citation

Vessey, M P., et al. "Epidemiology of Endometriosis in Women Attending Family Planning Clinics." BMJ (Clinical Research Ed.), vol. 306, no. 6871, 1993, pp. 182-4.
Vessey MP, Villard-Mackintosh L, Painter R. Epidemiology of endometriosis in women attending family planning clinics. BMJ. 1993;306(6871):182-4.
Vessey, M. P., Villard-Mackintosh, L., & Painter, R. (1993). Epidemiology of endometriosis in women attending family planning clinics. BMJ (Clinical Research Ed.), 306(6871), 182-4.
Vessey MP, Villard-Mackintosh L, Painter R. Epidemiology of Endometriosis in Women Attending Family Planning Clinics. BMJ. 1993 Jan 16;306(6871):182-4. PubMed PMID: 8338516.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Epidemiology of endometriosis in women attending family planning clinics. AU - Vessey,M P, AU - Villard-Mackintosh,L, AU - Painter,R, PY - 1993/1/16/pubmed PY - 1993/1/16/medline PY - 1993/1/16/entrez KW - Age Factors KW - Barrier Methods KW - Biology KW - Bleeding KW - Cohort Analysis KW - Contraception KW - Contraceptive Methods KW - Demographic Factors KW - Developed Countries KW - Diseases KW - Endometrial Effects KW - Endometrium KW - Endoscopy KW - England KW - Europe KW - Examinations And Diagnoses KW - Family Planning KW - Family Planning Programs KW - Genitalia KW - Genitalia, Female KW - Iud KW - Laparoscopy KW - Laparotomy KW - Northern Europe KW - Oral Contraceptives KW - Pain KW - Physical Examinations And Diagnoses KW - Physiology KW - Population KW - Population Characteristics KW - Research Methodology KW - Research Report KW - Scotland KW - Signs And Symptoms KW - Surgery KW - Treatment KW - United Kingdom KW - Urogenital System KW - Uterus KW - Vaginal Barrier Methods KW - Vaginal Diaphragm SP - 182 EP - 4 JF - BMJ (Clinical research ed.) JO - BMJ VL - 306 IS - 6871 N2 - 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. SN - 0959-8138 UR - https://www.unboundmedicine.com/medline/citation/8338516/Epidemiology_of_endometriosis_in_women_attending_family_planning_clinics_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&amp;PAGE=linkout&amp;SEARCH=8338516.ui DB - PRIME DP - Unbound Medicine ER -