Prevalence Ratio of Body Mass Index and Age at Menarche with Endometriosis Among Gynecology Patients: A Retrospective Cross-Sectional Study

In: Jurnal Kesehatan · 2026 · vol. 17(2) , pp. 294–299 · doi:10.26630/jk.v17i2.5926 · W7214212999
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This retrospective cross-sectional study of gynecology patients found that abnormal BMI was significantly associated with a higher prevalence of endometriosis, whereas age at menarche showed no significant association.

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This retrospective cross-sectional study analyzed medical records from 69 gynecology patients to evaluate the association between body mass index, age at menarche, and the presence of endometriosis. The researchers found no statistically significant link between age at menarche and endometriosis status, but identified that abnormal BMI was significantly associated with a higher prevalence of the condition, showing a prevalence ratio of 1.57 compared to women with normal BMI. The authors explicitly note that due to the cross-sectional design, causal interpretation is not warranted, although the data supports an association with elevated BMI. This paper is centrally about endometriosis, specifically investigating demographic and anthropometric risk factors including body mass index and age at menarche within a hospital-based patient cohort.

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Abstract

Endometriosis is a chronic gynecological disorder characterized by the growth of endometrial-like tissue outside the uterine cavity, often accompanied by chronic pelvic pain and infertility. Age at menarche and body mass index (BMI) have been proposed as factors associated with endometriosis, yet earlier findings remain inconsistent. This study examined the association between age at menarche, BMI, and he presence of endometriosis. This observational analytic study used secondary data from medical records of gynecology patients at Fatmawati Central General Hospital, Jakarta. Sixty-nine records that met the eligibility criteria were included consecutively. Endometriosis status served as the outcome, while age at menarche and BMI were the independent variables. Data were summarized descriptively and analyzed with the chi-square test; associations were expressed as prevalence ratios (PR) with 95% confidence intervals (CI), and p < 0.05 was considered statistically. Most participants were older than 40 years (62.3%), had menarche after 13 years (63.8%), and had an abnormal BMI (62.3%); endometriosis was documented in 43.5% of the records. Results found no significant association was observed between age at menarche and endometriosis (p = 0.947; PR = 0.947; 95% CI: 0.640-1.519). Abnormal BMI, by contrast, was significantly associated with endometriosis (p = 0.031; PR = 1.571; 95% CI: 1.057-2.336), with a prevalence 1.57 times higher than among women with normal BMI. In this hospital-based sample, abnormal BMI was associated with a higher prevalence of endometriosis, but because this was a cross-sectional design, age at menarche was not given and causal interpretation is not warranted.
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Prevalence Ratio of Body Mass Index and Age at Menarche with Endometriosis Among Gynecology Patients: A Retrospective Cross-Sectional Study DOI: https://doi.org/10.26630/jk.v17i2.5926Keywords: Body Mass Index, Menarche, WomanAbstract Endometriosis is a chronic gynecological disorder characterized by the growth of endometrial-like tissue outside the uterine cavity, often accompanied by chronic pelvic pain and infertility. Age at menarche and body mass index (BMI) have been proposed as factors associated with endometriosis, yet earlier findings remain inconsistent. This study examined the association between age at menarche, BMI, and he presence of endometriosis. This observational analytic study used secondary data from medical records of gynecology patients at Fatmawati Central General Hospital, Jakarta. Sixty-nine records that met the eligibility criteria were included consecutively. Endometriosis status served as the outcome, while age at menarche and BMI were the independent variables. Data were summarized descriptively and analyzed with the chi-square test; associations were expressed as prevalence ratios (PR) with 95% confidence intervals (CI), and p < 0.05 was considered statistically. Most participants were older than 40 years (62.3%), had menarche after 13 years (63.8%), and had an abnormal BMI (62.3%); endometriosis was documented in 43.5% of the records. Results found no significant association was observed between age at menarche and endometriosis (p = 0.947; PR = 0.947; 95% CI: 0.640-1.519). Abnormal BMI, by contrast, was significantly associated with endometriosis (p = 0.031; PR = 1.571; 95% CI: 1.057-2.336), with a prevalence 1.57 times higher than among women with normal BMI. In this hospital-based sample, abnormal BMI was associated with a higher prevalence of endometriosis, but because this was a cross-sectional design, age at menarche was not given and causal interpretation is not warranted. References Allaire, C., Bedaiwy, M. A., & Yong, P. J. (2023). Diagnosis and management of endometriosis. Canadian Medical Association Journal, 195(10), E363-E371. https://doi.org/10.1503/cmaj.220637 Becker, C. M., Bokor, A., Heikinheimo, O., Horne, A., Jansen, F., Kiesel, L., King, K., ... Yazbeck, C. (2022). ESHRE guideline: Endometriosis. Human Reproduction Open, 2022(2). https://doi.org/10.1093/hropen/hoac009 Chen, S., Liu, Y., Zhong, Z., Wei, C., Liu, Y., & Zhu, X. (2023). Peritoneal immune microenvironment of endometriosis: Role and therapeutic perspectives. Frontiers in Immunology, 14, 1134663. https://doi.org/10.3389/fimmu.2023.1134663 Comptour, A., Figuier, C., Pereira, B., Chauvet, P., Bourdel, N., & Canis, M. (2024). Endometriosis: Age at diagnosis and the severity of the disease. Journal of Gynecology Obstetrics and Human Reproduction, 53(5), 102759. https://doi.org/10.1016/j.jogoh.2024.102759 Garmendia, J. V., De Sanctis, C. V., Hajdúch, M., & De Sanctis, J. B. (2025). Endometriosis: An immunologist's perspective. International Journal of Molecular Sciences, 26(11), 5193. https://doi.org/10.3390/ijms26115193 Kim, H. J., Lee, H. S., Kazmi, S. Z., Hann, H. J., Kang, T., Cha, J., Choi, S. B., Swan, H., Kim, H. J., Lee, Y. S., & Ahn, H. (2021). Familial risk for endometriosis and its interaction with smoking, age at menarche and body mass index: A population-based cohort study among siblings. BJOG: An International Journal of Obstetrics & Gynaecology, 128(12), 1938-1948. https://doi.org/10.1111/1471-0528.16769 Kim, M. R., Chapron, C., Römer, T., Aguilar, A., Chalermchockcharoenkit, A., Chatterjee, S., Dao, L. T. A., ... Yen, C. F. (2022). Clinical diagnosis and early medical management for endometriosis: Consensus from Asian Expert Group. Healthcare, 10(12), 2515. https://doi.org/10.3390/healthcare10122515 McDonnell, R., Gollow, J., Nathan, E., Doherty, D., Majumder, K., Wilkinson, E., McElhinney, B., Karthigasu, K., & Hart, R. (2025). Endometriosis Quality of Life Cohort Study: Long-term impact of radical laparoscopic excision of endometriosis. Gynecology and Minimally Invasive Therapy, 14(1), 57-65. https://doi.org/10.4103/gmit.gmit_156_23 Missmer, S. A. (2004). Incidence of laparoscopically confirmed endometriosis by demographic, anthropometric, and lifestyle factors. American Journal of Epidemiology, 160(8), 784-796. https://doi.org/10.1093/aje/kwh275 Ministry of Health Republic Indonesia RI. (2024). Profil Kesehatan Indonesia 2023. Jakarta: Ministry of Health Republic Indonesia. Ottolina, J., Villanacci, R., D'Alessandro, S., He, X., Grisafi, G., Ferrari, S. M., & Candiani, M. (2024). Endometriosis and adenomyosis: Modern concepts of their clinical outcomes, treatment, and management. Journal of Clinical Medicine, 13(14), 3996. https://doi.org/10.3390/jcm13143996 Petraglia, F., Vannuccini, S., Dolmans, M. M., Speciale, A. R., Bourdon, M., Marcellin, L., Donnez, J., & Chapron, C. (2025). The endocrine aspects of endometriosis. European Journal of Endocrinology, 193(4), R17-R30. https://doi.org/10.1093/ejendo/lvaf192 Taylor, H. S., Kotlyar, A. M., & Flores, V. A. (2021). Endometriosis is a chronic systemic disease: Clinical challenges and novel innovations. The Lancet, 397(10276), 839-852. https://doi.org/10.1016/S0140-6736(21)00389-5 Usman, F., Reza, G. S., & Handayani, E. (2022). The relationship between age of menarche and body mass index (BMI) with endometriosis incidence at Dr. Mohammad Hoesin Palembang period 2018-2020. Bioscientia Medicina: Journal of Biomedicine and Translational Research, 6(4), 1586-1591. https://doi.org/10.37275/bsm.v6i4.477 World Health Organization. (2023). Endometriosis [Fact sheet]. https://www.who.int/news-room/fact-sheets/detail/endometriosis Downloads Published Issue Section License Copyright (c) 2026 Aneila Putri Fatimah , Meiyanti This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License. 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