Examining the co-occurrence of endometriosis and polycystic ovarian syndrome

Karen C Schliep; Lina Ghabayen; May Shaaban; Felicity R Hughes; Anna Z Pollack; Joseph B Stanford; Kristy Allen Brady; Amber Kiser; C Matthew Peterson

doi:10.1016/j.xagr.2023.100259

Examining the co-occurrence of endometriosis and polycystic ovarian syndrome

AJOG Glob Rep. 2023 Aug 28;3(3):100259. doi: 10.1016/j.xagr.2023.100259. eCollection 2023 Aug.

Authors

Karen C Schliep¹, Lina Ghabayen¹, May Shaaban¹, Felicity R Hughes¹, Anna Z Pollack², Joseph B Stanford¹, Kristy Allen Brady³, Amber Kiser⁴, C Matthew Peterson⁵

Affiliations

¹ Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT (Dr Schliep, Mses Ghabayen, Shaaban, and Hughes, and Dr Stanford).
² College of Health and Human Services, George Mason University, Fairfax, VA (Dr Pollack).
³ Department of Internal Medicine, University of Utah, Salt Lake City, UT (Dr Allen Brady).
⁴ Department of Biomedical Informatics, University of Utah, Salt Lake City, UT (Ms Kiser).
⁵ Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT (Dr Peterson).

Abstract

Background: Polycystic ovarian syndrome and endometriosis are 2 of the most common reproductive disorders among women but are thought to be unrelated.

Objective: This study aimed to examine the overlap and common symptoms of polycystic ovarian syndrome and endometriosis.

Study design: The study population included the Endometriosis, Natural History, Diagnosis, and Outcomes Study (2007-2009) operative cohort: 473 women, aged 18 to 44 years, who underwent a diagnostic and/or therapeutic laparoscopy or laparotomy at 1 of 14 surgical centers located in Salt Lake City, Utah, or San Francisco, California, in addition to a population cohort composed of 127 women from the surgical centers' catchment areas. Age and site-adjusted multinomial regression models were used to estimate adjusted prevalence ratios and 95% confidence intervals of reproductive history characteristics among women with endometriosis only, women with polycystic ovarian syndrome only, and women with both endometriosis and polycystic ovarian syndrome.

Results: Among the operative cohort, 35% had endometriosis only, 9% had polycystic ovarian syndrome only, and 5% had endometriosis and polycystic ovarian syndrome. Among the population cohort, 10% had endometriosis only, 8% had polycystic ovarian syndrome only, and 2% had endometriosis and polycystic ovarian syndrome. In the operative cohort, a history of subfertility was associated with a higher adjusted probability of having both conditions (adjusted prevalence ratio, 10.33; 95% confidence interval, 3.94-27.08), followed by having endometriosis only (adjusted prevalence ratio, 2.45; 95% confidence interval, 1.56-3.84) or polycystic ovarian syndrome only (adjusted prevalence ratio, 1.15; 95% confidence interval, 0.51-2.61), than having neither condition. In addition, experiencing chronic pelvic pain within the past 12 months was associated with a higher probability of having both conditions (adjusted prevalence ratio, 2.53; 95% confidence interval, 1.07-6.00) than having neither condition.

Conclusion: Among a cohort of women undergoing gynecologic laparoscopy or laparotomy, our study found that nearly 1 in 20 women had both an incident endometriosis diagnosis and symptoms consistent with polycystic ovarian syndrome. Among a population cohort of women not seeking gynecologic care, polycystic ovarian syndrome and endometriosis overlap prevalence was approximately 1 in 50 women.

Keywords: endometriosis; epidemiology; pelvic pain; polycystic ovarian syndrome; subfertility.

Abstract

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