Premium
Can symptomatology help in the diagnosis of endometriosis? Findings from a national case–control study—Part 1
Author(s) -
Ballard KD,
Seaman HE,
De Vries CS,
Wright JT
Publication year - 2008
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.2008.01878.x
Subject(s) - endometriosis , medicine , odds ratio , irritable bowel syndrome , pelvic pain , logistic regression , obstetrics , gynecology , case control study , surgery
Objective To determine the value of patient‐reported symptoms in diagnosing endometriosis. Design A national case–control study. Setting Data from the UK General Practice Research Database for years 1992–2001. Sample 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. Main outcome measures 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.