Evaluation of Factors Associated with Endometriosis and Clinical Treatments in Bangladesh: Case-control study (Preprint)

BACKGROUND Endometriosis is a gynecological condition that involves the implantation of endometrial tissue outside the uterine cavity. About 1.2 million women are suffering from this disease in Bangladesh OBJECTIVE The purpose of this study was to explore the factors associated with endometriosis, symptoms, and clinical treatment in Bangladesh. METHODS In this case-control study, out of 162 women, 82 had endometriosis confirmed with laparoscopy/ transvaginal ultrasound and 80 were included in the control group with normal pelvic ultrasound. All were asked to fill out a questionnaire containing demographics, reproductive, and menstrual status. Comparisons between the two groups were done using an Independent t-test, Chi-square test and logistic regression model. P-value < .05 was considered statistically significant. RESULTS The prevalence of endometriosis was higher with, age 25.78 ± 5.36 (P = .01), marital status, and BMI (P < .05). The most common symptoms were dysmenorrhea, excessive bleeding, cramping etc. Infertility (OR:2.21; %95CI: 1.07–4.53; P = .03), thyroid imbalance (OR:3.44; %95CI: 1.47–8.03; P = .004), irregular menstruation (OR:5.76; %95CI: 2.12–15.60; P = .001), age at menarche (OR:2.54; %95CI: 1.04–6.21; P = .04) were the factor that associated with endometriosis. Endometriosis was diagnosed most frequently by TVS (transvaginal ultrasound) at 45.1%, NSAI (nonsteroidal aromatase inhibitors) at 22.8% was the most commonly utilized medicine, and 17.9% of patients undergo laparoscopy for surgical treatment CONCLUSIONS This study identified several factors significantly associated with endometriosis among infertile women in Bangladesh. The prevalence of endometriosis was notably higher among women with increased age, specific marital statuses, and elevated BMI. Common symptoms included dysmenorrhea, excessive bleeding, and cramping. Key associated factors were infertility, thyroid imbalance, irregular menstruation and early age at menarche. Transvaginal ultrasound emerged as the most frequently used diagnostic method, while nonsteroidal aromatase inhibitors were the most common form of medical treatment. These findings emphasize the importance of early screening and targeted interventions, as well as the need to enhance clinical awareness and access to care for women at risk of endometriosis.