Polycystic Ovary Syndrome, Endometriosis, and Venous Thromboembolism: A Population-Based Study

BACKGROUND: There is a paucity of studies on the association between polycystic ovary syndrome (PCOS) and endometriosis and the occurrence of venous thromboembolism (VTE). OBJECTIVE: Our study aimed to evaluate the association between PCOS, endometriosis, deep vein thrombosis (DVT), and pulmonary embolism (PE). METHODS: This was a retrospective study of prospectively collected data using the Healthcare Cost and Utilization Project databases. We examined the association between PCOS and endometriosis with DVT and PE from a cohort of 12,814,970 female patients, aged 18-49 years, who were hospitalized between 2007 and 2014. RESULTS: We observed increasing trends, with a relative increase of 140% (from 0.27% to 0.65%) for PCOS, 16% (from 0.43% to 0.50%) for DVT, and 39% (from 0.23% to 0.32%) for PE, whereas we observed a decline by 34% for endometriosis (from 0.85% to 0.56%). The unadjusted analysis showed an association between PCOS and VTE, which remained significant after adjustment for sociodemographic characteristics and comorbidities (OR = 2.16; 95% CI: 2.00-2.33 and OR = 2.44; 95% CI: 2.23-2.67 for DVT and PE, respectively). The association between endometriosis and VTE was age-dependent, with an increased risk of VTE among women 18-24 years whereas this risk was decreased among those 35 years and older. CONCLUSION: Our study indicates an association between PCOS and VTE and an age-dependent association between endometriosis and VTE.