Sexual activity, contraception, and reproductive factors in predicting endometriosis.
To examine the belief that women with endometriosis have "voluntarily" delayed childbirth, the authors used a case-control approach to assess the relation between sexual, contraceptive, and reproductive factors and endometriosis. A total of 104 laparoscopically confirmed newly diagnosed cases of endometriosis were identified from a gynecologic specialty clinic in western New York state in 1987. Two control groups were used: 1) 100 friend controls, and 2) 98 medical controls. No differences were found between study groups on use of reliable birth control, use of birth control before a first pregnancy, age at first intercourse, frequency of intercourse, decisions to delay pregnancy, age at first pregnancy, or measures of body size. Cases were older than medical controls by about 1 year when they first began using birth control (19.8 vs. 18.6 years, p < 0.05). Cases were also 1 year older than friend controls when they began regular intercourse (20.9 vs. 19.5 years, p < 0.005) and at first marriage (22.8 vs. 21.7 years, p < 0.05). A larger percentage of cases than friend controls were never pregnant (p < 0.0001) and were more likely to have problems becoming pregnant (p < 0.0001). Results, overall, do not support simplistic assumptions that characterize endometriosis patients as career women who voluntarily delay pregnancy. Rather, the results point to a complex relation between endometriosis and reproductive, sexual activity, and fertility-related factors.
Darrow
S L
SL
Department of Social and Preventive Medicine, School of Medicine and Biomedical Sciences, SUNY, Buffalo.
Selman
S
S
Batt
R E
RE
Zielezny
M A
MA
Vena
J E
JE
D000328:Adult; D016022:Case-Control Studies; D003267:Contraception / Q000706:statistics & numerical data; D003625:Data Collection; D004715:Endometriosis / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D005260:Female; D005298:Fertility; D006801:Humans; D017533:Marital Status; D008423:Maternal Age; D012098:Reproduction / Q000502:physiology; D012725:Sexual Behavior / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D013240:Stereotyping