Influence of employment status on menopausal symptoms

Objective

To evaluate the variation of climacteric symptoms among working and nonworking postmenopausal Turkish women.

Methods

This cross-sectional study enrolled a random sample of 132 women (66 employed, 66 not employed). Sociodemographic data were collected through a sociodemographic questionnaire. Menopause symptomatology was assessed using the Climacteric Complaint Tool.

Results

All women had a similar sociodemographic background. A significantly greater percentage of nonworking women suffered from hot flushes, difficulty in sleeping, headache, irritability, depressive mood, muscle and joint pain, and urinary problems. Multivariate logistic regression analysis showed that the employment status had a significant effect on the experience of climacteric symptoms even after adjustments for education status and income adequacy.

Conclusions

The present study indicates that the employment status might contribute to significant variations in climacteric symptomatology.     

Impact of the tension-free vaginal tape obturator procedure on sexual function in women with stress urinary incontinence

Objective

To evaluate prospectively the impact of the tension-free vaginal tape obturator (TVT-O) procedure on sexual function in women with stress urinary incontinence (SUI).

Methods

The present prospective study included women with SUI and no concomitant prolapse who underwent a TVT-O procedure at Fuzhou General Hospital in Fuzhou, Fujian, China. Before and 6 months after surgery, the patients had their sexual function evaluated using the Female Sexual Function Index (FSFI) questionnaire. Only sexually active women were included in the final analysis.

Results

Among the 55 sexually active patients, 21.8% had coital incontinence, which was cured in 11 of 12 patients (91.7%). More than half (54.5%) the women reported an improvement in sexual function after surgery and 45.5% reported no change. No statistically significant difference was found between preoperative and postoperative total or domain (desire, arousal, lubrication, orgasm, satisfaction, and pain) scores on the FSFI.

Conclusion

The TVT-O procedure in women with SUI did not significantly affect sexual function. Further studies are needed to verify the findings and compare the impact of TVT-O on sexual function with that of other anti-incontinence procedures.     

Sexual dysfunction among women of low-income status in an urban setting

Objective

To determine demographic and clinical conditions associated with sexual dysfunction among women of low-income status living in an urban setting.

Methods

Cross-sectional study of 102 consecutive women attending an urban gynecology clinic. Women were given validated questionnaires to measure sexual function, depression, urinary incontinence, and erectile dysfunction in the partner. The association of sexual dysfunction with demographic variables, depression, urinary incontinence, and sexual function in the partner was assessed by the respondent.

Results

The prevalence of sexual dysfunction was 37.3% (n = 38). Women with sexual dysfunction reported significantly lower scores on all subscales of sexual function compared with women without sexual dysfunction. Women with sexual dysfunction were more likely to be older (33 ± 11.2 vs 28.7 ± 8.6; P < 0.04), unemployed (68% vs 47%; P < 0.03), and report depression (OR 4.4; 95% CI, 1.7-11.3), urinary urge incontinence (OR 2.7; 95% CI, 1.2-7.3), and intake of multiple medications (OR 5.4; 95% CI, 1.6-20.1). On multivariate analysis, depression and urge urinary incontinence were independently associated with sexual dysfunction.

Conclusion

Female sexual dysfunction is associated with the presence of depression and urge urinary incontinence in women of low-income status living in an urban setting.     

A report on the reproductive health of women after the massive 2008 Wenchuan earthquake

Objective

To evaluate the reproductive health of women in the aftermath of the 2008 Richter scale 8.0 Wenchuan earthquake in China.

Methods

Gynecologists surveyed 170 women using a questionnaire inquiring about symptoms of reproductive tract infection, menstruation disorders, satisfaction with sexual life, and desire for fertility.

Results

The rates of symptoms of lower genital tract infection were higher after than before the earthquake (50.0% vs 26.5%), as were the rates for pelvic inflammatory disease (35.9% vs 19.4%) and menstruation disorders (51.8% vs 22.4%) (P < 0.05 for all). At the same time, the women's satisfaction with their sexual life was markedly decreased; 89.4% of them said they would not pursue a plan to become pregnant; and 67.1% said they would request pregnancy termination if they became pregnant.

Conclusion

The findings of this first population-based assessment of reproductive health following the massive Wenchuan earthquake may help in shaping public health measures benefiting women surviving large-sale disasters.     

The impact of prophylactic salpingo-oophorectomy on menopausal symptoms and sexual function in women who carry a BRCA mutation

Objective

Prophylactic salpingo-oophorectomy is recommended to women who carry a BRCA1 or BRCA2 mutation to reduce the risks of breast, ovarian and fallopian tube cancer. We measured the impact of prophylactic salpingo-oophorectomy on menopausal symptoms and sexual functioning in women with a BRCA mutation.

Methods

Women who underwent prophylactic salpingo-oophorectomy between October 1, 2002 and June 26, 2008 for a known BRCA1 or BRCA2 mutation were invited to participate. Participants completed questionnaires before prophylactic surgery and again one year after surgery. Measures of sexual functioning and menopausal symptoms before and after surgery were compared. Satisfaction with the decision to undergo prophylactic salpingo-oophorectomy was evaluated.

Results

114 women who underwent prophylactic surgery completed questionnaires before and one year after surgery. Subjects who were premenopausal at the time of surgery (n = 75) experienced a significant worsening of vasomotor symptoms (hot flashes, night sweats and sweating) and a decline in sexual functioning (desire, pleasure, discomfort and habit). The increase in vasomotor symptoms and the decline in sexual functioning were mitigated by HRT, but symptoms did not return to pre-surgical levels. HRT decreased vaginal dryness and dyspareunia; however, the decrease in sexual pleasure was not alleviated by HRT. Satisfaction with the decision to undergo prophylactic salpingo-oophorectomy remained high regardless of increased vasomotor symptoms and decreased sexual function.

Conclusions

Women who undergo prophylactic salpingo-oophorectomy prior to menopause experience an increase in vasomotor symptoms and a decrease in sexual functioning. These symptoms are improved by HRT, but not to pre-surgical levels.     

Prevalence of premenstrual syndrome and premenstrual dysphoric disorder in a representative cohort of Spanish women of fertile age

Objective

To assess the prevalence of premenstrual symptoms, premenstrual syndrome and premenstrual dysphoric disorder in a cohort of women of fertile age representative of the general Spanish population.

Study design

During the period between November 27th and December 22nd, 2008, a cross-sectional nationwide survey was conducted among a cohort of Spanish women aged between 15 and 49 years. Participants were personally interviewed at home and completed the premenstrual symptoms screening tool.

Results

Of the 2108 participants, 1554 women (73.7%) complained of some of the premenstrual symptoms during the last 12 menstrual cycles. A total of 1415 (91%) women presented isolated symptoms and 139 (8.9%) a moderate/severe premenstrual syndrome. Twenty-four (1.1%) women fulfilled criteria for a diagnosis of premenstrual dysphoric disorder.

Conclusion

The prevalence of premenstrual symptoms (73.7%) and premenstrual dysphoric disorder (1.1%) in Spanish women aged between 15 and 49 years is similar to that reported in other Western countries. Only women with moderate or severe premenstrual syndrome or premenstrual dysphoric disorder, however, had daily life activities significantly impaired by premenstrual symptoms.     

Older women's pregnancy related symptoms, health and use of antenatal services

Objective

The study aims to describe older women's self-reported pregnancy-related symptoms, health and use of antenatal services by parity.

Study design

The data were collected in a national survey of women who gave birth in one week in England in 2006. A random sample of 4800 participants was drawn via birth registration by the Office for National Statistics. Women were contacted at three months postpartum and a 63% response rate was achieved. Older women's (35 years or more, n = 692) experience of pregnancy-related symptoms and use of antenatal services were compared with those of younger women (<25 years n = 336 and 25-34 years, n = 1957) using logistic regression (odds ratios (ORs) and 95% confidence intervals (CI)) and adjusting for available confounding factors such as ethnicity, marital status, deprivation and education.

Results

The older women had fewer antenatal visits, overnight stays in hospital, and pregnancy-related symptoms than women aged <25 years. Overall, the most common symptoms were nausea 68%, heartburn 62%, and backache 51%. Symptom prevalence varied with age and parity. Compared with women aged <25 years older women were less likely to have vomiting (adjusted OR, 95% CI: 0.49, 0.35-0.70), backache (0.42, 0.32-0.55), and to experience depression (0.58, 0.37-0.90) and more likely to have haemorrhoids (1.81, 1.31-2.47). Compared with women aged 25-34 years they were less likely to have vomiting (0.76, 0.58-0.99) but more likely to have varicose veins (1.39, 1.03-1.88), haemorrhoids (1.60, 1.31-1.96), carpal tunnel syndrome (1.34, 1.03-1.75), and stress incontinence (1.35, 1.05-1.45).

Conclusion

Substantial numbers of women reported pregnancy-related symptoms likely to cause discomfort and affect daily life. Older women used antenatal health care less and experienced fewer symptoms but those reported were of the type that are more likely to persist after pregnancy, with the exception of depression, which was most commonly reported by the youngest women.     

The risk of urinary incontinence after partial urethral resection in patients with anterior vulvar cancer

Objective

The number of women with vulvar carcinoma located in the anterior fourchette in immediate proximity to the urethral opening has increased. A retrospective analysis was performed in order to evaluate the risk of urinary incontinence after tumor-resection, standard inguinal lymphadenectomy and additional partial urethral resection.

Study design

Between 2002 and 2007, 19 women with vulvar carcinomas located close to the urethral opening and consequently treated by additional partial urethral resection of up to 1.5 cm, were evaluated for urinary loss postoperatively by standard incontinence questionnaire. All patients complaining about some kind of urinary loss underwent urodynamic measurement. Results were compared with 21 controls (women with anterior vulvar cancer treated without urethral resection).

Results

Five of 19 women (26%) of the study group complained about urinary disturbances and received urodynamic evaluation. Ninety-five percent of the patients (18/19 women) were continent by urodynamic criteria; in one woman the measurement was unreliable. One patient in the control group (1/21 women) complained of an increase of urge symptoms that had been present preoperatively.

Conclusions

Twenty-six percent of our patients after partial urethral resection reported incontinence symptoms, though this was not always confirmed by urodynamics. We conclude that the risk of urinary stress incontinence after partial urethral resection in anterior vulvar carcinoma is acceptable.     

Sexual violations among married women in southeastern Nigeria

Objective

To investigate domestic sexual violations in southeastern Nigeria and the opinions of married women regarding sexual rights for women.

Method

Married women attending gynecologic clinics at 3 major hospitals in Enugu, Nigeria, completed a structured questionnaire.

Results

A culture of male dominance seemed to be the leading cause for the following high rates: husband's total monopoly on decisions regarding sex, 54.1%; inability to refuse the husband's demands for sex, 60.7%; sex-related verbal abuse, 39.3%; sex-related physical violence, 16.2%; and forced sex, 19.1%. Women with a university education and unemployed women reported sexual violations more frequently than did others. Most respondents supported sexual rights for women.

Conclusion

Married women in southeastern Nigeria still are denied sexual rights, apparently owing to a culture of male dominance. A higher education alone may not lead to the advent of sexual rights for women, and a greater emphasis should be placed on societal reorientation.     

Urodynamic findings in women with pelvic organ prolapse and obstructive voiding symptoms

Objective

To determine whether obstructive voiding symptoms in women with advanced pelvic organ prolapse (POP) were associated with objective bladder outflow tract obstruction.

Methods

We reviewed preoperative data from patients with advanced POP who underwent surgical correction at the Department of Obstetrics and Gynecology, Carmel Medical Center, Haifa, Israel, between December 1, 2005, and November 30, 2007. Obstructive voiding symptoms were recorded from Pelvic Floor Distress Inventory-20 questionnaires.

Results

Of the 81 women aged 44-80 years who were included in the study, 40 (49.4%) reported incomplete bladder emptying preoperatively. There was no significant difference between these women and asymptomatic women in terms of demographic and clinical parameters such as age, parity, and stage of prolapse. Furthermore, there was no significant difference with regard to postvoid residual bladder volume (52.8 ± 65.8 vs 41.6 ± 41.2 mL), maximal (23.8 ± 11 vs 21.9 ± 9.6 mL/second) and average (10.3 ± 6.2 vs 9.3 ± 4 mL/second) urinary flow velocities, prevalence of increased postvoid residual volume (10.0% vs 4.8%), or obstructive urinary flow (17.5% vs 7.3%).

Conclusion

Almost half of all women with advanced POP experienced incomplete bladder emptying; however, this symptom did not correlate with objective urodynamic bladder outflow tract obstruction.     

Levator ani injury in primiparous women with forceps delivery for fetal distress, forceps for second stage arrest, and spontaneous delivery

Objective

To compare levator ani muscle injury rates in primiparous women who had a forceps delivery owing to fetal distress with women delivered by forceps for second stage arrest; and to compare these injury rates with a historical control group of women who delivered spontaneously.

Methods

Primiparous women who delivered by forceps were recruited retrospectively into 2 groups: forceps for fetal distress with short second stage (25 ± 11 minutes; n = 19); and forceps delivery for second stage arrest (137 ± 26 minutes; n = 19). MR images of the levator ani muscles were compared with a historical control group of women from a previous study who had delivered spontaneously (n = 129).

Results

Major defect rates were: 42% for forceps and short second stage; 63% for forceps and second stage arrest; and 6% for spontaneous delivery. The odds ratios for major injury were: 11.0 for forceps and short second stage compared with spontaneous delivery; 25.9 for forceps and second stage arrest compared with spontaneous delivery; and 2.3 for forceps and second stage arrest compared with short second stage (P = 0.07).

Conclusion

Women delivered by forceps have a higher rate of levator ani injury compared with spontaneous delivery controls; the difference between the forceps groups did not reach significance.     

The prevalence of fecal incontinence and urinary incontinence in primiparous postpartum Chinese women

Objective

This study investigated the prevalence of fecal incontinence (FI) and urinary incontinence (UI) in primiparous postpartum Chinese women.

Study design

Questionnaires about FI and UI symptoms were completed via telephone interviews conducted within 6 months postpartum.

Results

A total of 1889 primiparous postpartum women were asked to participate in this investigation. Only 13 (0.69%) of them had FI within 6 months after parturition, including loss of flatus in six women (0.32%), loss of solid stool in one (0.05%), loss of liquid stool in two (0.11%) and fecal urgency in four (0.21%). Bivariate logistic regression analysis showed that FI was significantly associated with forceps delivery OR = 37.91 (95% CI 4.20-342.18, P = 0.001) and medio-lateral episiotomy OR = 11.79 (95% CI 1.47-94.46, P = 0.02). The prevalence of UI, stress urinary incontinence (SUI), urge urinary incontinence (UUI) and mixed urinary incontinence (MUI) was 9.9% (186), 8.0% (151), 1.0% (18) and 0.9% (17), respectively. Multinomial logistic regression analysis found that SUI prevalence was related to age OR = 1.08 (95% CI 1.04-1.12, P = 0.000), maternal weight OR = 1.04 (95% CI 1.02-1.06, P = 0.001), neonate head circumference OR = 1.17 (95% CI 1.01-1.36, P = 0.043), spontaneous labor OR = 5.42 (95% CI 2.60-11.32, P = 0.000), forceps delivery OR = 7.0 (95% CI 2.40-20.41, P = 0.000), and medio-lateral episiotomy OR = 5.24 (95% CI 3.15-8.72, P = 0.000).

Conclusions

1. FI and UI prevalence was lower in our department than reported in previous studies in other areas. 2. Vaginal delivery has a risk impact on women's FI and UI, especially forceps delivery and medio-lateral episiotomy. 3. Maternal age, weight, newborn head circumference, spontaneous vaginal delivery, forceps delivery, and medio-lateral episiotomy increase the risk of UI.     

Assessment of bone mineral density should be considered earlier in perimenopausal women with vasomotor symptoms

Objective

To investigate the relationship between vasomotor symptoms (hot flashes) and osteopenia or osteoporosis in perimenopausal women.

Method

In this cross-sectional study 79 perimenopausal women aged between 45 and 55 years and seen at the Gynecology or Menopause Outpatient Clinic of Marmara University School of Medicine were allotted to one of 2 groups according to the presence or absence of hot flashes. The groups were then compared for bone mineral density (BMD) of the lumbar vertebrae, as measured by dual energy X-ray absorptiometry.

Results

The mean BMD measurement for vertebrae L2 to L4 was 0.32 ± 0.19 for the group with no hot flashes and  − 0.53 ± 0.21 for the group with hot flashes (P = 0.007). In the former, 6.1% of the women and in the latter, 32.6% of the women had a BMD value less than a 1.5 standard deviation from the mean (P = 0.005).

Conclusion

Women with vasomotor symptoms are more prone to have osteopenia or osteoporosis.     

Attitudes of Spanish women toward premenstrual symptoms, premenstrual syndrome and premenstrual dysphoric disorder: results of a nationwide survey

Objective

To assess the attitudes of women with premenstrual symptoms in relation to their perception of complaints and request for medical advice.

Study design

Cross-sectional study of a representative cohort of 2018 Spanish women aged 15-49 years. Participants were personally interviewed at home and completed the premenstrual symptoms screening tool.

Results

A total of 1554 women (73.7%) complained of some of the premenstrual symptoms during the last 12 menstrual cycles. The prevalence of moderate or severe premenstrual syndrome (PMS) was 8.9% and the prevalence of premenstrual dysphoric disorder (PMDD) 1.1%. Only 291 (18.7%) women had sought medical advice. The main reason given by 90.6% of symptomatic women for not seeking medical consultation was to consider that symptoms were normal. A total of 175 (60.1%) women received pharmacological treatment (hormonal contraceptives in 95% followed by analgesics in 50% and anti-inflammatory agents in 44%), 20% were not treated because physicians considered that symptoms were not important and would disappear spontaneously, and 12% received only advice to change life style.

Conclusion

Women suffering from PMS or PMDD do not usually seek medical advice and among those seeking medical care, in many cases, an adequate response to their demands is not obtained.     

Epidemiology of mixed urinary incontinence in China

Objectives

To determine the prevalence and risk factors for mixed urinary incontinence (MUI) among Chinese women.

Method

In this cross-sectional survey study we analyzed the answers to a modified Bristol Female Lower Urinary Tract Symptoms questionnaire provided by 19 024 women older than 20 years and from 6 regions in China.

Results

The overall prevalence of MUI was 9.4%. The prevalence of MUI increased with age and reached 24.1% among women older than 70 years. Multivariable logistic regression analysis revealed that age, vaginal delivery, chronic constipation, pelvic organ prolapse, chronic pelvic pain, respiratory system disease, menstrual disorder, urinary system disease, alcohol consumption, pelvic surgery, obesity, and a low educational level were independent risk factors for MUI.

Conclusion

We found age, vaginal delivery, and chronic constipation to be the main risk factors for MUI among adult women in China.     

Coerced sexual debut and lifetime abortion attempts among women in Rakai, Uganda

Objective

To assess whether reported coercion at sexual debut is associated with a greater lifetime risk of attempting an abortion among women in Rakai, Uganda.

Methods

Analysis of data from sexually experienced, ever-pregnant women in a longitudinal, population-based, open cohort study in 56 rural communities in Rakai, Uganda (n = 4784). For univariate analysis, the t test was used for continuous variables and the Pearson χ² or Fisher exact tests for categorical variables. Multivariate logistic regression was used to control for potential confounding.

Results

Twenty percent of women reported coercion at sexual debut. Compared with women who reported consensual sexual debut, the adjusted odds ratio (OR) of subsequent abortion attempts among coerced women was 1.57 (95% CI, 1.11-2.20).

Conclusion

There is a need to protect women from sexual coercion, implement policies for prevention of violence, and provide comprehensive reproductive health care, including prevention of unwanted pregnancy and unsafe abortions.     

A study of symptoms described by ovarian cancer survivors

Objective

A cross-sectional, observational study to evaluate physical and psychological symptoms experienced by patients following completion of treatment for ovarian cancer and compared to symptoms documented in their hospital notes.

Methods

Women attending follow-up clinic at Hammersmith Hospital having undergone treatment for primary or relapsed ovarian cancer were asked to complete two validated questionnaires (EORTC QLQ-C30 and QLQ-OV28) and a “wellbeing thermometer”. Results were assessed and stratified by patient age, tumour stage, relapse status, type of chemotherapy received and treatment-free interval. Symptoms reported in questionnaires were compared to those documented in patients' hospital notes.

Results

Of 116 women approached, 100 (86%) participated in this study and had received chemotherapy for ovarian cancer between 2003 and 2010. The most frequently described and severe symptoms reported in the questionnaires were emotional symptoms, negative feelings about treatment or prognosis, fatigue and pain. Dyspareunia, cognitive impairment and peripheral neuropathy were also frequently described. Symptom severity was independent of variables such as disease stage, type of chemotherapy received and relapse status. The “wellbeing thermometer” scores closely correlated with pain, fatigue, weakness, gastrointestinal symptoms and attitude to disease or treatment (p < 0.001). There was a marked discordance between questionnaire-reported symptoms and those recorded in hospital notes.

Conclusions

The majority of women surveyed experienced persistent psychological and physical symptoms following ovarian cancer treatment; in particular: psychological concerns, sexual inactivity and fatigue, all potentially reversible with appropriate interventions. Our results highlight the extent of symptoms described by ovarian cancer survivors and the need for them to be adequately acknowledged and addressed.     

Concomitant surgical correction of occult stress urinary incontinence by TOT in patients with pelvic organ prolapse

Objectives

To assess the post-operative urinary incontinence states of pelvic organ prolapse cases operated on with concomitant trans-obturator tape (TOT) procedure.

Study design

Urodynamic evaluation of 79 patients with pelvic organ prolapse, before and after operation, while reducing the prolapsed organs by ring forceps placed bilaterally on the anterolateral sulcuses avoiding urethral compression. According to urodynamic tests, 25 patients were diagnosed as having occult stress urinary incontinence.

Results

Post-operative overactive bladder, stress urinary incontinence and mixed incontinence were found in three (12%), two (8%) and one (4%) patients of the occult stress urinary incontinence group, respectively. The corresponding numbers were six (11%), five (9%) and three (6%) in the continent group. No significant difference was found between the groups in terms of post-operative overactive bladder symptoms, stress urinary incontinence and mixed incontinence (Kruskal-Wallis test, X² = 0.52, p = 0.820).

Conclusions

This retrospective study suggests that a complete pre-operative urodynamic evaluation, including urodynamic tests at the time of POP reduction by placing ring forceps on the anterolateral sulcuses, is an efficient method for the diagnosis of occult symptomatic stress urinary incontinence (SUI). Prospective randomized studies are needed to establish the benefits and the risks of concomitant prophylactic surgery in patients with pelvic organ prolapse.     

Overactive bladder symptoms and uterine adenomyosis--is there any connection?

Objective

The aim of this study was to investigate a possible connection between uterine adenomyosis and the prevalence of symptoms of overactive bladder (OAB), and to study the impact of OAB symptoms on the quality of life (QoL) of women with uterine adenomyosis.

Study design

In this prospective pilot study, we included 98 women, 54 of them with an ultrasound (US) diagnosis of uterine adenomyosis and 44 with normal-appearing uterine myometrium during transvaginal US examination. After interview all women completed two questionnaires, the Urogenital Distress Inventory (UDI) and the Incontinence Impact Questionnaire. Data were analyzed with SPSS statistical software by means of non-parametric statistics and logistic regression.

Results

The average age of all the women was 44 years. Women from the adenomyosis and control groups did not differ in any of the observed clinical variables. Analysis of the UDI questionnaire showed that irritative symptoms were most prevalent in the adenomyosis group as compared to the control group, 22.3% and 7.8%, respectively. Urge urinary incontinence was found in 25.9% of women in the adenomyosis group (3.7% in the control group). Results of logistic regression confirmed the greatest negative impact of irritative symptoms on QoL in women with uterine adenomyosis (p < 0.000).

Conclusion

As compared with healthy controls, women with adenomyosis more often experience OAB symptoms which significantly decrease their QoL. The connection between adenomyosis and OAB remains uncertain.     

Prevalence and incidence of diagnosed endometriosis and risk of endometriosis in patients with endometriosis-related symptoms: findings from a statutory health insurance-based cohort in Germany

Objective

The objectives were: (a) to determine the administrative prevalence and incidence of endometriosis and (b) to assess the risk of endometriosis associated with endometriosis-related symptoms.

Study design

The study is based on inpatient and outpatient data from a statutory health insurance fund in Germany. For prevalence and incidence definition 62,323 women aged 15-54 continuously insured in 2007 were identified. The prevalence and incidence of endometriosis in 2007 were calculated standardized to the age distribution in Germany. In a further prospective cohort study based within the health insurance sample 2095 patients with endometriosis-related symptoms and 8380 age-matched asymptomatic controls were identified. Endometriosis follow-up was from 2004 to 2008. Cox proportional hazard regression was used to examine the risk of endometriosis associated with endometriosis-related symptoms, such as pelvic pain, dysmenorrhoea, dyspareunia, menorrhagia, post-coital bleeding, inter-menstrual pain and ovarian cysts. Relative risks (RR) and 95% confidence intervals (CI) were calculated.

Results

Standardized prevalence and incidence rates were 8.1 and 3.5 per 1000 women, respectively. The highest prevalence was observed in women aged 35-44 with 12.8 per 1000 women. Median follow-up was 4.5 years. Risk of endometriosis associated with endometriosis-related symptomatology was RR (95% CI) = 4.95 (3.67-6.68); 4.5% of all symptomatic women were diagnosed with endometriosis in a median follow-up of 4.5 years. The highest risk was observed in women aged 35-44 [RR (95% CI) = 6.29 (4.00-9.90)] with 7.6% of all symptomatic women receiving a diagnosis of endometriosis during the follow-up.

Conclusion

Prevalence estimates based on population-based administrative data were lower than described in the literature. Risk of endometriosis was increased in women with endometriosis-related symptoms. However, those symptoms were of limited predictive value for endometriosis as only a small proportion of symptomatic patients were diagnosed with endometriosis in the follow-up.