Is there an association between endometriosis and sexual activity during menstruation ?

Sexual activities leading to orgasm seem to be effective in the formation of endometriosis

Key Points

Background:

• In the pathogenesis of endometriosis retrograde menstruation is a widely accept­ed theory for the dissemination of endometrial tissue to the peritoneal cavity through uterine tubes.
• Ninety percent of women with open uterine tubes were found to have menstrual blood in their peritoneal cavities.
• It is assumed that the level and volume of retrograde menstruation and the backward movement of endometrial cells have significant effects.

Highlights:

• It is hypothesized that sexual activity leading to orgasm dur­ing menstruation may increase retrograde menstruation, seed­ing endometrial tissue in other locations.
• There are several contradictory results from previous researchers. 

What's Done Here?

• This case-control study consisted of 185 women with endometriosis versus 370 women in the control group.
• The authors examined the hypothesis of sexual activity leading to orgasm during menstruation.

Conclusions:

• The present study is consistent with the previously noted observation of higher prevalence of endometriosis among women of high socioeconomic and social status.
• The occurrence of endometriosis in women having vaginal intercourse or non-coital sexual activities, leading to orgasm during menstruation is statistically significantly higher compared to those who do not.
• The re­sults of the current study showed that the risk of endometriosis approximately was five times higher in women stating they had vaginal intercourse during menstruation compared to those who stated they did not.

Lay Summary

This recent case-control study with 185 women having endometriosis and  370 women as a control group was conducted in Tebriz University, Iran by Dr. Mollazadeh and associates. 

Contemporarily, retrograde menstruation is a valid theory for disseminating endometrial tissue to the peritoneal cavity through patent uterine tubes. Since about 90% of women with open uterine tubes has been found to have menstrual blood in their peritoneal cavities by laparoscopy, the level and volume of retrograde menstruation and the backward movement of endometrial cells are thought to be significant in this regard.

Sexual activity leading to orgasm dur­ing menstrual period may increase retrograde menstruation and thus, seed­ing of endometrial tissue in other locations may occur, leading to endometriosis. Several studies to reveal this issue showed inconsistent findings. This new case-control study has the same observation with the previously noted observations showing a higher prevalence of endometriosis among women with high socioeconomic and social status.

The major conclusion of this study is that the occurrence of endometriosis in women experiencing vaginal intercourse or non-coital sexual activities, with orgasms during menstruation is five times higher in comparison to those who do not.

"This study has raised interesting issues and requires further investigation to better understand the mechanism of occurrence of endometriosis in such cases", concluded the authors.

Research Source: https://www.ncbi.nlm.nih.gov/pubmed/31310078