{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T19:34:00Z","timestamp":1790883240073,"version":"4.1.0"},"reference-count":33,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,3,21]],"date-time":"2024-03-21T00:00:00Z","timestamp":1710979200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate whether an early need of hormonal contraceptive (HC), or a failure to find a suitable method, are warning signs for endometriosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Sweden.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Population<\/jats:title>\n                    <jats:p>The cohort consisted of 720\u2009805 women aged 12\u201327\u2009years during the period 2005\u20132017. All women, regardless of whether they received a diagnosis of endometriosis or not (reference group), were included.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used data from Swedish national registers. Risks are expressed as crude and adjusted hazard ratios (HRs and aHRs, respectively) with 95% confidence intervals (95%\u2009CIs), adjusted for age, education level, civil status, parity, country of birth, and diagnoses of infertility, dysmenorrhea or depression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>A diagnosis of endometriosis between 12 and 27\u2009years of age.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During this period, 3268 women were diagnosed with endometriosis (0.45%). Women who started HC at the ages of 12\u201314\u2009years had a higher risk of receiving the diagnosis (aHR\u20092.53, 95%\u2009CI 2.21\u20132.90) than those who began at age 17\u2009years or older. Having tried more types of HCs was associated with a twofold increased risk of endometriosis (more that three types of HC, aHR\u20092.31, 95%\u2009CI 1.71\u20133.12). Using HC for more than 1\u2009year was associated with a decreased risk of endometriosis (&gt;1\u2009year, aHR\u20090.53, 95%\u2009CI 0.48\u20130.59). Women with endometriosis more commonly had dysmenorrhea, depression or infertility.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The use of HCs at an early age and a failure to find a suitable HC were identified as warning signs of later receiving an endometriosis diagnosis. A longer duration of HC usage reduced the risk of receiving the diagnosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1471-0528.17812","type":"journal-article","created":{"date-parts":[[2024,3,21]],"date-time":"2024-03-21T05:40:30Z","timestamp":1710999630000},"page":"1352-1359","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Endometriosis risk and hormonal contraceptive usage: A nationwide cohort study"],"prefix":"10.1111","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0731-7169","authenticated-orcid":false,"given":"Cerisa","family":"Obern","sequence":"first","affiliation":[{"name":"Department of Women's and Children's Health Uppsala University  Uppsala 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