Early menstrual characteristics associated with subsequent diagnosis of endometriosis

Am J Obstet Gynecol. 2010 Jun;202(6):534.e1-6. doi: 10.1016/j.ajog.2009.10.857. Epub 2009 Dec 22.


Objective: The aim of this study was to investigate the association between early menstrual characteristics, before symptom onset, and later diagnosis of endometriosis.

Study design: This was a case-control study of 268 Australian women with surgically confirmed moderate-to-severe endometriosis (cases) and 244 women without endometriosis (controls). Early menstrual cycle characteristics, before age at symptom onset, were analyzed.

Results: Menarche after age 14 years was strongly and inversely associated with endometriosis (odds ratio, 0.3; 95% confidence interval, 0.1-0.6). A history of dysmenorrhea was associated with subsequent endometriosis (odds ratio, 2.6; 95% confidence interval, 1.1-6.2). Despite a suggestive trend, shorter menstrual cycle length was not associated with endometriosis. Duration of natural menstruation and heaviness of flow were not associated with subsequent risk of endometriosis; neither was the reported type of sanitary protection used nor history of sexual intercourse during menstruation.

Conclusion: There is a decreased risk of endometriosis with late age at menarche and an increased risk in women who report an early history of dysmenorrhea.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Age of Onset
  • Australia
  • Case-Control Studies
  • Child
  • Dysmenorrhea / complications*
  • Dysmenorrhea / diagnosis
  • Endometriosis / complications*
  • Endometriosis / diagnosis*
  • Female
  • Health Surveys
  • Humans
  • Menarche / physiology
  • Menstrual Cycle / physiology
  • Middle Aged
  • Odds Ratio
  • Surveys and Questionnaires