{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T12:04:33Z","timestamp":1788869073777,"version":"build-2803163510"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,1,12]],"date-time":"2025-01-12T00:00:00Z","timestamp":1736640000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,3,1]]},"abstract":"Abstract<\/jats:title>\n \n STUDY QUESTION<\/jats:title>\n Does endometriosis affect the mental health of women using oral contraceptives?<\/jats:p>\n <\/jats:sec>\n \n SUMMARY ANSWER<\/jats:title>\n Among oral contraceptive users, women with endometriosis have a higher risk of depression compared to those without endometriosis, although the absolute risk increase is small.<\/jats:p>\n <\/jats:sec>\n \n WHAT IS KNOWN ALREADY<\/jats:title>\n Previous studies have suggested a potential link between endometriosis and mental health issues, but the impact of endometriosis on depression among oral contraceptive users remains unclear.<\/jats:p>\n <\/jats:sec>\n \n STUDY DESIGN, SIZE, DURATION<\/jats:title>\n A secondary pooled cohort study utilizing data from two longitudinal patient-centric studies (INAS-VIPOS and PRO-E2) was conducted across 11 European countries, Colombia and Australia. The study included 93\u00a0541 women newly prescribed oral contraceptives, with or without endometriosis, and without a self-reported history of depression.<\/jats:p>\n <\/jats:sec>\n \n PARTICIPANTS\/MATERIALS, SETTING, METHODS<\/jats:title>\n Participant\u2019s mental health was captured using self-administered questionnaires at baseline and every 6\u201312\u2009months thereafter, asking about any newly occurred episodes of depression. Incidence rates (IRs) of self-reported depression were calculated per 10\u00a0000 woman-years. Absolute risk difference (ARD) and number needed to harm (NNH) were calculated with 95% CIs. The association between endometriosis and self-reported depression was estimated through crude and adjusted hazard ratios (HRs) with 95% CI, using stabilized inverse probability of treatment weighting (IPTW).<\/jats:p>\n <\/jats:sec>\n \n MAIN RESULTS AND THE ROLE OF CHANCE<\/jats:title>\n Of the included 93\u00a0541 women, 21\u00a0090 had endometriosis (49\u00a0541 woman-years) and 72\u00a0451 had no endometriosis (137\u00a0137 woman-years.) Of those with endometriosis, 308 (1.5%) reported an episode of depression (IR: 62.2\/10\u00a0000, 95% CI: 55.4\u201369.5) compared to 535 (0.7%) of women without endometriosis (IR 39.0\/10\u00a0000, 95% CI: 35.8\u201342.5). The ARD and NNH were 23.2 per 10\u00a0000 (95% CI: 15.2\u201330.9) and 431 (95% CI: 323.7\u2013657.0) respectively. The HR of depression in women with endometriosis was 1.85 (95% CI: 1.60\u20132.13) using stabilized IPTW to control for age, BMI, smoking, education, and age at menarche. Subgroup and sensitivity analyses showed similar results.<\/jats:p>\n <\/jats:sec>\n \n LIMITATIONS, REASONS FOR CAUTION<\/jats:title>\n While efforts were made to control for confounding factors, residual confounding may still exist. Additionally, the results can only be generalized to users of oral contraceptives.<\/jats:p>\n <\/jats:sec>\n \n WIDER IMPLICATIONS OF THE FINDINGS<\/jats:title>\n These results highlight the importance of considering the mental health implications of endometriosis among women using oral contraceptives. Further research is needed to explore additional contributing factors and potential interventions.<\/jats:p>\n <\/jats:sec>\n \n STUDY FUNDING\/COMPETING INTEREST(S)<\/jats:title>\n No funding was received for this study. No competing interests apply for this research.<\/jats:p>\n <\/jats:sec>\n \n TRIAL REGISTRATION NUMBER<\/jats:title>\n N\/A.<\/jats:p>\n <\/jats:sec>","DOI":"10.1093\/humrep\/deae299","type":"journal-article","created":{"date-parts":[[2025,1,2]],"date-time":"2025-01-02T15:17:19Z","timestamp":1735831039000},"page":"479-486","source":"Crossref","is-referenced-by-count":9,"title":["Endometriosis and risk of depression among oral contraceptive users: a pooled analysis of cohort studies from 13 countries"],"prefix":"10.1093","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-4197-529X","authenticated-orcid":false,"given":"P","family":"De Corte","sequence":"first","affiliation":[{"name":"Berlin Center for Epidemiology and Health Research , Berlin,","place":["Germany"]},{"name":"Institute of Public Health, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin , Berlin,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I","family":"Milhoranca","sequence":"additional","affiliation":[{"name":"Berlin Center for Epidemiology and Health Research , Berlin,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A S","family":"Oberg","sequence":"additional","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics, Karolinska Institutet , Stockholm,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7169-2620","authenticated-orcid":false,"given":"T","family":"Kurth","sequence":"additional","affiliation":[{"name":"Institute of Public Health, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin , Berlin,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Mechsner","sequence":"additional","affiliation":[{"name":"Endometriosis Centre Charit\u00e9, Department of Gynaecology, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin , Berlin,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K","family":"Heinemann","sequence":"additional","affiliation":[{"name":"Berlin Center for Epidemiology and Health Research , Berlin,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,1,12]]},"reference":[{"key":"2025041415291484400_deae299-B1","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1007\/s00439-020-02223-6","article-title":"Genetic analysis of endometriosis and depression identifies shared loci and implicates causal links with gastric mucosa abnormality","volume":"140","author":"Adewuyi","year":"2021","journal-title":"Hum Genet"},{"key":"2025041415291484400_deae299-B2","doi-asserted-by":"crossref","first-page":"1242","DOI":"10.1002\/sim.5984","article-title":"The use of propensity score methods with survival or time-to-event outcomes: reporting measures of effect similar to those used in randomized experiments","volume":"33","author":"Austin","year":"2014","journal-title":"Stat Med"},{"key":"2025041415291484400_deae299-B3","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1177\/0962280214543508","article-title":"Double propensity-score adjustment: a solution to design bias or bias due to incomplete matching","volume":"26","author":"Austin","year":"2017","journal-title":"Stat Methods Med Res"},{"key":"2025041415291484400_deae299-B4","doi-asserted-by":"crossref","first-page":"3661","DOI":"10.1002\/sim.6607","article-title":"Moving towards best practice when using inverse probability of treatment weighting (IPTW) using the propensity score to estimate causal treatment effects in observational studies","volume":"34","author":"Austin","year":"2015","journal-title":"Stat Med"},{"key":"2025041415291484400_deae299-B5","doi-asserted-by":"crossref","first-page":"e075289","DOI":"10.1136\/bmj-2022-075289","article-title":"What is my risk, doctor? 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