Can symptomatology help in the diagnosis of endometriosis? Findings from a national case-control study--Part 1.
OBJECTIVE
To determine the value of patient-reported symptoms in diagnosing endometriosis.


METHODS
A national case-control study.


METHODS
Data from the UK General Practice Research Database for years 1992-2001.


METHODS
A total of 5540 women aged 15-55 years, diagnosed with endometriosis, each matched to four controls without endometriosis.


METHODS
Data were analysed to determine whether specific symptoms were highly indicative of endometriosis. Odds ratios for these symptoms were derived by conditional logistic regression analysis.


METHODS
Symptoms associated with endometriosis.


RESULTS
The prevalence of diagnosed endometriosis was 1.5%. A greater proportion of women with endometriosis had abdominopelvic pain, dysmenorrhoea or menorrhagia (73%) compared with controls (20%). Compared with controls, women with endometriosis had increased risks of abdominopelvic pain (OR 5.2 [95% CI: 4.7-5.7]), dysmenorrhoea (OR 8.1 [95% CI: 7.2-9.3]), menorrhagia (OR 4.0 [95% CI: 3.5-4.5]), subfertility (OR 8.2 [95% CI: 6.9-9.9]), dyspareunia and/or postcoital bleeding (OR 6.8 [95% CI: 5.7-8.2]), and ovarian cysts (OR 7.3 [95% CI: 5.7-9.4]), and of being diagnosed with irritable bowel syndrome (IBS) (OR 1.6 [95% CI: 1.3-1.8]) or pelvic inflammatory disease (OR 3.0 [95% CI: 2.5-3.6]). Women with endometriosis were also found to consult the doctor more frequently than the controls and were twice as likely to have time off work.


CONCLUSIONS
Specific symptoms and frequent medical consultation are associated with endometriosis and appear useful in the diagnosis. Endometriosis may coexist with or be misdiagnosed as pelvic inflammatory disease or IBS.
Ballard
K D
KD
Department of Women's Health, Postgraduate Medical School, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK. k.ballard@surrey.ac.uk
Seaman
H E
HE
de Vries
C S
CS
Wright
J T
JT
D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D016022:Case-Control Studies; D004412:Dysmenorrhea; D004414:Dyspareunia / Q000209:etiology; D004715:Endometriosis / Q000150:complications / Q000175:diagnosis*; D005194:Family Practice / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000209:etiology; D043183:Irritable Bowel Syndrome / Q000209:etiology; D008595:Menorrhagia / Q000209:etiology; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D000292:Pelvic Inflammatory Disease / Q000209:etiology; D055815:Young Adult