Body mass index and the diagnosis of endometriosis: Findings from a national data linkage cohort study

Ingrid J Rowlands, Hockey R, Richard Hockey, Jason A Abbott, Abbott JA, Jason Abbott, Grant W Montgomery, Montgomery GW, Gita D Mishra, Mishra GD
Obesity research & clinical practice · 2022 · vol. 16(3) , pp. 235–241 · doi:10.1016/j.orcp.2022.04.002 · PMID:35431154 · W4223976843
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⚙ AI-generated summary by claude@2026-06+body, 2026-06-13 ⓘ

This study found that women who gained weight after age 18–23 had a lower risk of clinically confirmed endometriosis, while being overweight at age 18–23 was associated with a higher risk of clinically suspected endometriosis.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-09 · read from full text ⓘ

This national data linkage cohort study analyzed 11,794 Australian women (born 1989–95) who completed six surveys between 2013 and 2018, with survey data linked to administrative health records to identify endometriosis. Using Cox proportional hazards models, it assessed BMI at ages 18–23 and subsequent BMI change, stratifying outcomes by diagnostic method: clinically confirmed endometriosis from hospital discharge diagnoses versus clinically suspected endometriosis based on women’s reports of physician-diagnosed disease. Women who gained weight after ages 18–23 had a lower risk of clinically confirmed endometriosis (HR 0.64, 95% CI 0.47–0.88), while overweight at 18–23 was associated with a higher risk of clinically suspected endometriosis (HR 1.29, 95% CI 1.01–1.66). This paper is centrally about endometriosis — it examines how BMI and weight change relate to endometriosis risk across confirmed and suspected diagnostic pathways.

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Abstract

BackgroundWomen with lower body mass index (BMI) have a higher risk of surgically confirmed endometriosis but this finding runs counterintuitive to the oestrogen-dependent theory for the disease. Increasingly, endometriosis is diagnosed via non-surgical methods. We examined BMI at age 18-23 years, and changes in BMI, and the risk of endometriosis according to the diagnostic method.MethodsWe analysed data from 11 794 young women, born in 1989-95, who completed six surveys as part of an Australian, longitudinal cohort study between 2013 and 2018. Women's survey responses were linked to administrative health records to identify endometriosis. Cox proportional hazards models modelled associations between BMI at age 18-23 years, and changes in BMI, and endometriosis. Analyses were stratified by the diagnostic method of endometriosis: clinically confirmed endometriosis (based on hospital discharge diagnosis) versus clinically suspected endometriosis (women's reports of physician-diagnosed endometriosis).ResultsThere were 223 cases of clinically confirmed endometriosis and 396 cases of clinically suspected endometriosis. Women who gained weight after age 18-23 had lower risk of clinically confirmed endometriosis than women without endometriosis whose weight remained stable (HR = 0.64, 95% CI = 0.47-0.88). Women who were overweight (HR = 1.29, 95% CI = 1.01-1.66) at age 18-23 had higher risk of clinically suspected endometriosis than women of normal weight without endometriosis.ConclusionsThe risk of clinically confirmed endometriosis was lower among women who gained weight compared to women with stable weight. The risk of clinically suspected endometriosis was higher among women who were overweight compared to normal weight.
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Abstract Background: Women with lower body mass index (BMI) have a higher risk of surgically confirmed endometriosis but this finding runs counterintuitive to the oestrogen-dependent theory for the disease. Increasingly, endometriosis is diagnosed via non-surgical methods. We examined BMI at age 18–23 years, and changes in BMI, and the risk of endometriosis according to the diagnostic method. Methods: We analysed data from 11 794 young women, born in 1989–95, who completed six surveys as part of an Australian, longitudinal cohort study between 2013 and 2018. Women's survey responses were linked to administrative health records to identify endometriosis. Cox proportional hazards models modelled associations between BMI at age 18–23 years, and changes in BMI, and endometriosis. Analyses were stratified by the diagnostic method of endometriosis: clinically confirmed endometriosis (based on hospital discharge diagnosis) versus clinically suspected endometriosis (women's reports of physician-diagnosed endometriosis). Results: There were 223 cases of clinically confirmed endometriosis and 396 cases of clinically suspected endometriosis. Women who gained weight after age 18–23 had lower risk of clinically confirmed endometriosis than women without endometriosis whose weight remained stable (HR = 0.64, 95% CI = 0.47–0.88). Women who were overweight (HR = 1.29, 95% CI = 1.01–1.66) at age 18–23 had higher risk of clinically suspected endometriosis than women of normal weight without endometriosis. Conclusions: The risk of clinically confirmed endometriosis was lower among women who gained weight compared to women with stable weight. The risk of clinically suspected endometriosis was higher among women who were overweight compared to normal weight.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Overweight Overweight Overweight Overweight Overweight Overweight Overweight Overweight Overweight Adolescent Adolescent

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