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American Journal of Epidemiology Vol. 140, No. 6: 500-509
Copyright © 1994 by The Johns Hopkins University School of Hygiene and Public Health

research-article

Sexual Activity, Contraception, and Reproductive Factors in Predicting Endometriosis

Sherri L. Darrow1,2,, Sharon Selman1,2, Ronald E. Batt3, Maria A. Zielezny1 and John E. Vena1

1Department of Social and Preventive Medicine, School of Medicine and Biomedical Sciences SUNY, Buffalo, NY
2Roswell Park Cancer Institute Buffalo, NY
3Department of Gynecology-Obstetrics, School of Medicine and Biomedical Sciences SUNY, Buffalo, NY

Reprint requests to Dr. Sherri L. Darrow, The Cancer Information Service, Roswell Park Cancer Institute, Elm and Canton Streets, Buffalo, NY 14263

To examine the belief that women with endometriosis have "voluntarily" delayed childbirth, the authors used a case-control approach to assess the relation between sexual, contraceptive, and reproductive factors and endometriosis. A total of 104 laparoscopically confirmed newly diagnosed cases of endometriosis were Identified from a gynecologic specialty clinic in western New York state in 1987. Two control groups were used: 1)100 friend controls, and 2) 98 medical controls. No differences were found between study groups on use of reliable birth control, use of birth control before a first pregnancy, age at first Intercourse, frequency of intercourse, decisions to delay pregnancy, age at first pregnancy, or measures of body size. Cases were older than medical controls by about 1 year when they first began using birth control (19.8 vs. 18.6 years, p < 0.05). Cases were also 1 year older than friend controls when they began regular intercourse (20.9 vs. 19.5 years, p < 0.005) and at first marriage (22.8 vs. 21.7 years, p < 0.05). A larger percentage of cases than friend controls were never pregnant (p < 0.0001) and were more likely to have problems becoming pregnant (p < 0.0001). Results, overall, do not support simplistic assumptions that characterize endometriosis patients as career women who voluntarily delay pregnancy. Rather, the results point to a complex relation between endometriosis and reproductive, sexual activity, and fertility-related factors.

contraception behavior; endometriosis; fertility; reproduction; sex behavior


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