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      Endometriosis 

      Endometriosis: Epidemiology, and Etiological Factors

      edited_book
      , ,
      Wiley-Blackwell

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          Endometriosis: epidemiology and aetiological factors.

          Estimates of the frequency of endometriosis vary widely. Based on the few reliable data, the prevalence of the condition can reasonably be assumed to be around 10%. Although no consistent information is available on the incidence of the disease, temporal trends suggest an increase among women of reproductive age. This could be explained-at least in part-by changing reproductive habits. Numerous epidemiological studies have indicated that nulliparous women and women reporting short and heavy menstrual cycles are at increased risk of developing endometriosis; data on other risk factors are less consistent. These epidemiological findings strongly support the menstrual reflux hypothesis. Additional evidence in favour of this theory includes the demonstration of viable endometrial cells in the menstrual effluent and peritoneal fluid, experimental implantation and growth of endometrium within the peritoneal cavity, observation of some degree of retrograde menstruation in most women undergoing laparoscopy during menses, and an association between obstructed menstrual outflow and endometriosis.
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            Incidence of laparoscopically confirmed endometriosis by demographic, anthropometric, and lifestyle factors.

            The authors investigated the relations of demographic, anthropometric, and lifestyle factors with endometriosis in the Nurses' Health Study II prospective cohort. During 10 years of follow-up (1989-1999), 1,721 cases of laparoscopically confirmed endometriosis were reported among women with no past infertility. The incidence rate was greatest among women aged 25-29 years and lowest among women over 44 years (p(trend) 30 vs. 19-20.4 kg/m(2): rate ratio = 0.8, 95% confidence interval: 0.6, 1.1; p(trend) = 0.004) and with current alcohol intake (for >10 vs. 0 g/day: rate ratio = 0.7, 95% confidence interval: 0.6, 0.8; p(trend) < 0.0001) but no association with height, waist/hip ratio, or caffeine intake. An inverse relation with current body mass index and current cigarette smoking was observed only when cases were concurrently infertile. The authors conclude that age, race, body mass index, alcohol use, and cigarette smoking are associated with the incidence of endometriosis and that some of these relations may differ by infertility status at the time of laparoscopic diagnosis.
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              High rates of autoimmune and endocrine disorders, fibromyalgia, chronic fatigue syndrome and atopic diseases among women with endometriosis: a survey analysis.

              Women with endometriosis may also have associated disorders related to autoimmune dysregulation or pain. This study examined whether the prevalence of autoimmune, chronic pain and fatigue and atopic disorders is higher in women with endometriosis than in the general female population. A cross-sectional survey was conducted in 1998 by the Endometriosis Association of 3680 USA members with surgically diagnosed endometriosis. Almost all responders had pain (99%), and many reported infertility (41%). Compared with published rates in the general USA female population, women with endometriosis had higher rates of hypothyroidism (9.6 versus 1.5%, P < 0.0001), fibromyalgia (5.9 versus 3.4%, P < 0.0001), chronic fatigue syndrome (4.6 versus 0.03%, P < 0.0001), rheumatoid arthritis (1.8 versus 1.2%, P = 0.001), systemic lupus erythematosus (0.8 versus 0.04%, P < 0.0001), Sjögren's syndrome (0.6 versus 0.03%, P < 0.0001) and multiple sclerosis (0.5 versus 0.07%, P < 0.0001), but not hyperthyroidism or diabetes. Allergies and asthma were more common among women with endometriosis alone (61%, P < 0.001 and 12%, P < 0.001 respectively) and highest in those with fibromyalgia or chronic fatigue syndrome (88%, P < 0.001 and 25%, P < 0.001 respectively) than in the USA female population (18%, P < 0.001 and 5%, P < 0.001 respectively). Hypothyroidism, fibromyalgia, chronic fatigue syndrome, autoimmune diseases, allergies and asthma are all significantly more common in women with endometriosis than in women in the general USA population.
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                Book Chapter
                January 25 2012
                : 19-26
                10.1002/9781444398519.ch2
                16aee3d9-bd75-4fe0-8e4f-9db0da4bcd94
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