Risk Factors for Endometriosis in a German Case–Control Study

Stefanie Burghaus, S Burghaus, P Klingsiek, Peter Klingsiek, P A Fasching, PA Fasching, Anne Engel, A Engel, L Häberle, Lothar Häberle, Pamela L. Strissel, P L Strissel, Manuel Schmidt, M Schmidt, Katherine Jonas, K Jonas, Johanna Strehl, J D Strehl, Arndt Hartmann, A Hartmann, J Lermann, Johannes Lermann, A Boosz, Alexander Boosz, F C Thiel, Falk C. Thiel, Andreas Müller, A Müller, MW Beckmann, M W Beckmann, S P Renner, Stefan P. Renner
Geburtshilfe und Frauenheilkunde · 2011 · vol. 71(12) , pp. 1073–1079 · doi:10.1055/s-0031-1280436 · PMID:25253901 · PMC4166917 · W2055889369
article OA: bronze CC0 ⤵ 31 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-09 ⓘ

This German case-control study identified longer menstrual cycles, longer menstrual bleeding, more miscarriages, and smoking as risk factors for endometriosis, while age at menarche, live births, contraceptive pill use, and BMI were not predictive.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-10 ⓘ

This hospital-based German case–control study (Bavarian Endometriosis Study) analyzed epidemiological risk factors using laparoscopy-confirmed endometriosis cases and hospital controls without prior abdominal surgery or pelvic pain syndrome, recruiting women from 2001–2010 and collecting questionnaire data on reproductive history, menstrual cycle characteristics, BMI, and smoking. After age-matching, 298 cases and 300 controls were evaluated with logistic regression models predicting case–control status. The study found that cycle length, duration of menstrual bleeding, number of pregnancies, number of miscarriages, and smoking status were significant predictors, while age at menarche, number of live births, ever use of contraceptive pills, and BMI were not predictive in the multivariable model. This paper is centrally about endometriosis — it identifies epidemiological risk factors for endometriosis in a German case–control cohort.

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Abstract

Objective: The etiology of endometriosis is still a research field in which few consistent data are available. Large case–control studies or even cohort studies are rare, and most of the published data are conflicting. The aim of the present study was therefore to examine common epidemiological and endometriosis-specific risk factors in a German case–control study. Design: From 2001 to 2010, a pool of 595 laparoscopically confirmed cases and 475 controls were recruited in a hospital-based setting. After matching for age, 298 cases and 300 controls remained in the pool. Age at menarche, menstrual cycle length, duration of menstrual bleeding, number of pregnancies, live births, miscarriages, use of contraceptive pills, body mass index (BMI), and smoking status were analyzed with logistic regression models predicting endometriosis case–control status. Results: Menstrual cycle length, duration of menstrual bleeding, number of pregnancies, number of miscarriages, and smoking status, as relevant predictors for endometriosis case–control status, were identified as risk factors for endometriosis. Other factors such as age at menarche, number of live births, ever having used contraceptive pills, and BMI were not predictive. Conclusions: This hospital-based case–control study reproduced most of the familiar risk factors. Comparison of this study with others reveals a wide variety of effect sizes and directions of association with risk factors and may increase the information available about the characteristics of the patient population being treated in the relevant hospital setting.

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endometriosis

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