Risk for and consequences of endometriosis: A critical epidemiologic review

A. L. Shafrir, L. V. Farland, D. K. Shah, H. R. Harris, M. Kvaskoff, K. Zondervan, S. A. Missmer

Research output: Contribution to journalReview articlepeer-review

357 Scopus citations


Endometriosis affects approximately 10% of women of reproductive age. Characteristics robustly associated with a greater risk for endometriosis include early age at menarche, short menstrual cycle length, and lean body size, whereas greater parity has been associated with a lower risk. Relationships with other potential characteristics including physical activity, dietary factors, and lactation have been less consistent, partially because of the need for rigorous data collection and a longitudinal study design. Critical methodologic complexities include the need for a clear case definition; valid selection of comparison/control groups; and consideration of diagnostic bias and reverse causation when exploring demographic characteristics, medical history, and lifestyle factors. Reviewers and editors must demand a detailed description of rigorous methods to facilitate comparison and replication to advance our understanding of endometriosis.

Original languageEnglish (US)
Pages (from-to)1-15
Number of pages15
JournalBest Practice and Research: Clinical Obstetrics and Gynaecology
StatePublished - Aug 2018


  • Comorbidities
  • Endometriosis
  • Epidemiology
  • Incidence
  • Risk factors
  • Study design

ASJC Scopus subject areas

  • Obstetrics and Gynecology


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