Adenomyosis and endometriosis in the California Teachers Study.
OBJECTIVE
To evaluate the reproductive and lifestyle correlates of a surgically confirmed diagnosis of endometriosis or adenomyosis in a large prospective cohort.


METHODS
Collection of surgical diagnoses of endometriosis and adenomyosis during follow-up of women with no prior history of endometriosis and no prior surgery for adenomyosis.


METHODS
The California Teachers Study (CTS), an ongoing prospective study of female teachers and school administrators established from the rolls of the California State Teachers Retirement System.


METHODS
Women with surgical diagnoses of endometriosis and adenomyosis were identified from California statewide hospital patient discharge records for CTS cohort members with an intact uterus and no prior history of endometriosis. Women with an incident surgical diagnosis of endometriosis (n = 229) or adenomyosis (n = 961) were compared with disease-free women in the same age range (for endometriosis, n = 43,493; for adenomyosis, n = 79,495).


METHODS
None.


METHODS
Multivariable logistic regression methods were used to calculate prevalence odds ratios and associated 95% confidence intervals for the associations between self-reported menstrual and reproductive characteristics and either endometriosis or adenomyosis.


RESULTS
Women surgically diagnosed with endometriosis were younger than those surgically diagnosed with adenomyosis. Factors statistically significantly associated with endometriosis were having a mother or sister with endometriosis and nulligravidity. Factors statistically significantly associated with adenomyosis were increasing parity, early menarche (<or=10 years of age), and short menstrual cycles (<or=24 days in length). Obese women also were more likely to have a surgical diagnosis of adenomyosis.


CONCLUSIONS
These observations provide the first epidemiologic profile of women with a surgical diagnosis of adenomyosis and indicate that this profile differs from that of women with a surgical diagnosis of endometriosis. Our results also suggest that adenomyosis but not endometriosis is associated with increased endogenous exposure to estrogen.
Templeman
Claire
C
Department of Obstetrics and Gynecology, University of Southern California Keck School of Medicine, Los Angeles, California, USA. clairetempleman@earthlink.net
Marshall
Sarah F
SF
Ursin
Giske
G
Horn-Ross
Pamela L
PL
Clarke
Christina A
CA
Allen
Mark
M
Deapen
Dennis
D
Ziogas
Argyrios
A
Reynolds
Peggy
P
Cress
Rosemary
R
Anton-Culver
Hoda
H
West
Dee
D
Ross
Ronald K
RK
Bernstein
Leslie
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D002140:California / Q000453:epidemiology; D002648:Child; D015331:Cohort Studies; D004715:Endometriosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008572:Menarche; D008597:Menstrual Cycle; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors