Adenomyosis and endometriosis in the California Teachers Study
Received 27 March 2007; received in revised form 7 June 2007; accepted 7 June 2007. published online 05 October 2007.
Objective
To evaluate the reproductive and lifestyle correlates of a surgically confirmed diagnosis of endometriosis or adenomyosis in a large prospective cohort.
Design
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.
Setting
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.
Patient(s)
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).
Intervention(s)
None.
Main Outcome Measure(s)
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.
Result(s)
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 (≤10 years of age), and short menstrual cycles (≤24 days in length). Obese women also were more likely to have a surgical diagnosis of adenomyosis.
Conclusion(s)
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.
Reprint request: Claire Templeman, M.D., Department of Obstetrics and Gynecology, University of Southern California, Womens and Childrens Hospital, 1240 Mission Road, Room L1009, Los Angeles, CA 90033 (FAX: 323-226-3509).
Supported by grants R01 CA77398 from the National Cancer Institute and contract 97-10500 from the California Breast Cancer Research Fund.
ABSTRACT