title: Menstruation, the oral contraceptive pill, and acute appendicitis.
abstract: OBJECTIVE
  To find out if there was any association between histologically confirmed acute appendicitis, menstruation, and the use of the oral contraceptive pill.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  District general hospital, Scotland.
  
  
  METHODS
  366 consecutive patients (median age 21, range 10-51) with histologically confirmed acute appendicitis during the period 1981-1990 were studied, 314 of whom were having menstrual cycles. 208 patients with physiological menstrual cycle were included in the study, and 82 patients were taking the oral contraceptive pill.
  
  
  METHODS
  Prospectively collected standardised data using computer assisted diagnosis of acute abdominal pain was used to review patients with histologically confirmed acute appendicitis.
  
  
  RESULTS
  Acute appendicitis was confirmed in 17/208 of patients (8%) who were menstruating, which is significantly less than might be expected (p < 0.003). 5/82 (6%) of those taking oral contraception had withdrawal bleeding and acute appendicitis (p = 0.2).
  
  
  CONCLUSIONS
  Acute appendicitis is less common among women during physiological menstruation, but no differences are noted during the withdrawal bleeding phase when taking oral contraception.
authors.affiliation: Department of Surgery, St John's Hospital at Howden, Livingston, United Kingdom.
authors.forename: N
authors.initials: N
authors.lastname: Evgenikos
authors.forename: J
authors.initials: J
authors.lastname: McLaren
authors.forename: D A
authors.initials: DA
authors.lastname: Macleod
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D001064:Appendicitis / Q000175:diagnosis / Q000453:epidemiology* / Q000276:immunology; D002648:Child; D003276:Contraceptives, Oral; D003936:Diagnosis, Computer-Assisted; D005260:Female; D006801:Humans; D008297:Male; D008598:Menstruation / Q000502:physiology*; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D003276:Contraceptives, Oral