Epidemiology of endometriosis in women attending family planning clinics.

Martin Vessey, M P Vessey, L Villard-Mackintosh, L Villard‐Mackintosh, Rosemary Painter, R Painter
BMJ (Clinical research ed.) · 1993 · vol. 306(6871) , pp. 182–184 · doi:10.1136/bmj.306.6871.182 · PMID:8338516 · W1970997691
article OA: bronze CC0 ⤵ 161 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This cohort study found endometriosis risk was low in current oral contraceptive and IUD users but higher in former users, while diaphragms showed no association.

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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.

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Condition tags

mesh:D004715endometriosis

MeSH descriptors

Contraceptive Devices, Female Contraceptives, Oral Endometriosis Pelvic Neoplasms Adult Age Factors Cohort Studies Endometriosis England England Family Planning Services Female Humans Parity Pelvic Neoplasms Risk Factors Time Factors

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (9)

Cited by (50)

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