Risk for and consequences of endometriosis: A critical epidemiologic review

Best Pract Res Clin Obstet Gynaecol. 2018 Aug:51:1-15. doi: 10.1016/j.bpobgyn.2018.06.001. Epub 2018 Jul 3.


Endometriosis affects approximately 10% of women of reproductive age. Characteristics robustly associated with a greater risk for endometriosis include early age at menarche, short menstrual cycle length, and lean body size, whereas greater parity has been associated with a lower risk. Relationships with other potential characteristics including physical activity, dietary factors, and lactation have been less consistent, partially because of the need for rigorous data collection and a longitudinal study design. Critical methodologic complexities include the need for a clear case definition; valid selection of comparison/control groups; and consideration of diagnostic bias and reverse causation when exploring demographic characteristics, medical history, and lifestyle factors. Reviewers and editors must demand a detailed description of rigorous methods to facilitate comparison and replication to advance our understanding of endometriosis.

Keywords: Comorbidities; Endometriosis; Epidemiology; Incidence; Risk factors; Study design.

Publication types

  • Review

MeSH terms

  • Age Factors
  • Case-Control Studies
  • Comorbidity
  • Endometriosis / diagnosis
  • Endometriosis / epidemiology
  • Endometriosis / etiology*
  • Female
  • Humans
  • Incidence
  • Longitudinal Studies
  • Menstrual Cycle
  • Pregnancy
  • Research Design
  • Risk Factors