Indirect assessment of endometriosis prevalence in general population

The prevalence of endometriosis among women who have already given birth is around ten percent.

Key Points

Highlights:

• The prevalence of endometriosis is estimated to be 10 percent in the general population, calculated through women who have already given birth at least once.

Importance:

• It is very difficult to estimate the prevalence of endometriosis in the general population.
• This study provides an estimate based on the prevalence of endometriosis in women undergoing laparoscopic sterilization.

What’s done here?

• The prevalence of endometriosis in women undergoing tubal sterilization by laparoscopy assessed in 17 published reports ranged between 1.4% to 43.3%.
• This study evaluated the prevalence of endometriosis in 465 women who underwent sterilization, reasoning that women seeking sterilization have likely already given birth at least once and usually have no major complaints, such as pelvic pain. 
• Endometriosis was identified visually in 55 of the 465 women (11.82 percent) and confirmed by histopathology in more than 90 percent of cases (in 50 of the 55 women).

Key results:

• The prevalence of endometriosis identified during sterilization was 11.82 percent.
• The prevalence of endometriosis among women who have already given birth at least once and who are asymptomatic was 10 percent.
• The prevalence of endometriosis was slightly increased in women who had never given birth with associated pain and a tilted uterus

Limitations of the study:

• The study only provides an estimate of the prevalence of endometriosis in the general population.

Lay Summary

The prevalence of endometriosis is 10 percent among the general population, estimates a study published in the Journal of Gynecology Obstetrics and Human Reproduction.

It is very difficult to estimate the prevalence of endometriosis in the general population. Seventeen different research articles have been published assessing the prevalence of endometriosis in women undergoing tubal sterilization. The results of these studies showed a huge variation in the prevalence of endometriosis ranging from 1.4 percent to 43.3 percent.  

In order to identify a close representation of endometriosis in the general population, a team of researchers led by Dr. Audebert at Institut Robert-B.-Greenblatt in Bordeaux, France described the prevalence of endometriosis identified during sterilization operations. They reasoned that since women seeking sterilization have likely already given birth at least once and usually have no major complaints, such as pelvic pain, they represent a good model to indirectly assess the prevalence of endometriosis in the general population. 

They analyzed 465 women, ages 15 to 49 who underwent sterilization between 1989 and 2009 at a center of gynecologic surgery. A total of 20 women had never given birth before while 12 had a past history of endometriosis. Endometriosis was identified visually in 55 of the 465 women (11.82 percent) and confirmed by histopathology analysis in more than 90 percent of cases (in 50 of the 55 women).

A total of 39 women had stage 1 endometriosis, seven had stage 2, eight had stage 3, and only one had stage 4 endometriosis. Among the 20 women who had never given birth, the prevalence of endometriosis was 20 percent. At the time of sterilization, 91 women had either menstrual cramps or pain during sexual intercourse. Of those, 16 were diagnosed with endometriosis. Among women who had already given birth at least once and who did not have any symptoms, the prevalence of endometriosis was 10 percent. Although there was an increase in the prevalence of endometriosis in women who had never given birth due to pelvic pain and tilted uterus, this was not statistically significant.  

The authors concluded that the prevalence of endometriosis is 10 percent among women who have already given birth at least once. 

Research Source: https://www.ncbi.nlm.nih.gov/pubmed/28526518