{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T01:11:48Z","timestamp":1791421908285,"version":"4.3.3"},"reference-count":8,"publisher":"BMJ","issue":"6871","license":[{"start":{"date-parts":[[1993,1,16]],"date-time":"1993-01-16T00:00:00Z","timestamp":727142400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.bmj.com\/company\/legal-information\/terms-conditions\/legal-information\/tdm-licencepolicy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ"],"published-print":{"date-parts":[[1993,1,16]]},"abstract":"<jats:p>OBJECTIVE--To describe the epidemiology of endometriosis in women attending family planning clinics with special reference to contraceptive methods. DESIGN--Non-randomised cohort study with follow up of subjects for up to 23 years. Disease was measured by first hospital admission rates since endometriosis can be diagnosed with accuracy only at laparotomy or laparoscopy. SETTING--17 family planning centres in England and Scotland. SUBJECTS--17,032 married white women aged 25-39 years at entry during 1968-74 who were taking oral contraceptives or using an intrauterine device or diaphragm. About 99% of the women approached agreed to participate and annual loss to follow up was about 0.3%. MAIN OUTCOME MEASURES--Diagnosis of endometriosis, age, parity, and history of contraceptive use. RESULTS--Endometriosis was significantly related to age, peaking at ages 40-44 (chi 2 for heterogeneity = 30.9, p &lt; 0.001). Endometriosis was not linked to duration of taking oral contraceptives. Nevertheless, the risk of endometriosis was low in women currently taking oral contraceptives (relative risk 0.4; 95% confidence interval 0.2 to 0.7), but higher in women who had formerly taken them (1.8; 1.0 to 3.1 in women who had stopped 25-48 months previously) compared with women who had never taken the pill. A similar pattern was seen for use of intrauterine devices (relative risk 0.4 (0.2 to 0.7) in current users and 1.4 (0.4 to 3.2) in users 49-72 months previously compared with never users). No association was found between endometriosis and use of the diaphragm. CONCLUSIONS--Oral contraceptives seem to temporarily suppress endometriosis. Endometriosis may be diagnosed late in women using intrauterine devices as pain and bleeding occur with both.<\/jats:p>","DOI":"10.1136\/bmj.306.6871.182","type":"journal-article","created":{"date-parts":[[2009,3,30]],"date-time":"2009-03-30T08:16:37Z","timestamp":1238400997000},"page":"182-184","source":"Crossref","is-referenced-by-count":168,"title":["Epidemiology of endometriosis in women attending family planning clinics."],"prefix":"10.1136","volume":"306","author":[{"given":"M P","family":"Vessey","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L","family":"Villard-Mackintosh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R","family":"Painter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[1993,1,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1904","DOI":"10.1001\/jama.1986.03370140102032","article-title":"The relation of endometriosis to menstrual characteristics, smoking, and exercise","volume":"255","author":"Cramer, D.W.; Wilson, E.; Stillman, R.J.; Bergen, M.J.; Belisle, S.; Schiff, I.","year":"1986","unstructured":"Cramer DW, Wilson E, Stillman RJ, Bergen MJ, Belisle S, Schiff I, et al. The relation of endometriosis to menstrual characteristics, smoking, and exercise. JAMA 1986;255:1904-8.","journal-title":"JAMA"},{"key":"ref_2","first-page":"373","article-title":"A long term follow up study of women using different methods of contraception: an interim report","volume":"8","author":"Vessey, M.P.; Doll, R.; Peto, R.; Johnson, B.; Wiggins, P.","year":"1976","unstructured":"Vessey MP, Doll R, Peto R, Johnson B, Wiggins P. A long term follow up study of women using different methods of contraception: an interim report. IJBiosoc Sci 1976;8:373-427.","journal-title":"IJBiosoc Sci"},{"key":"ref_3","first-page":"762","article-title":"Endometriosis in Lebanon. A casecontrol study","volume":"124","author":"Obermeyer, C.M.; Armenian, H.K.; Azoury, R.","year":"1986","unstructured":"Obermeyer CM, Armenian HK, Azoury R. Endometriosis in Lebanon. A casecontrol study. Am7Epidemiol 1986;124:762-7."},{"key":"ref_4","article-title":"General Practitioners. Oral contraceptives and health: an interim report front the oral contraceptive study of the Royal College of General Practitioners","author":"of, Royal College","year":"1974","unstructured":"Royal College of General Practitioners. Oral contraceptives and health: an interim report front the oral contraceptive study of the Royal College of General Practitioners. London: Pitman Medical Publishing, 1974."},{"key":"ref_5","article-title":"The Walnut Creek contraceptive drug study: a prospective study of the side effects of oral contraceptives","author":"Ramcharan, S.; Pellegrin, F.A.; Ray, R.; Hsu, J.-P.","year":"81-564.)","unstructured":"Ramcharan S, Pellegrin FA, Ray R, Hsu J-P. The Walnut Creek contraceptive drug study: a prospective study of the side effects of oral contraceptives. Vol III. Bethesda: National Institutes of Health, 1981. (Center for Population Research Monograph, Publication No 81-564.)"},{"key":"ref_6","first-page":"829","article-title":"Contraception: a risk factor for endometriosis","volume":"71","author":"Kirshon, B.; Poindexter, A.N.","year":"1988","unstructured":"Kirshon B, Poindexter AN. Contraception: a risk factor for endometriosis. Obstet Gynecol 1988;71:829-31.","journal-title":"Obstet Gynecol"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1093\/oxfordjournals.humrep.a137377","article-title":"Prevalence and genesis of endometriosis","volume":"6","author":"Mahmood, T.A.; Templeton, A.","year":"1991","unstructured":"Mahmood TA, Templeton A. Prevalence and genesis of endometriosis. Hum Reprod 1991;6:544-9.","journal-title":"Hum Reprod"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"451","DOI":"10.3109\/00016348709022053","article-title":"Endometriosis in women at interval sterilization","volume":"66","author":"Moen, M.H.","year":"1987","unstructured":"Moen MH. Endometriosis in women at interval sterilization. Acta Obstet Gynecol Scand 1987;66:451-4.","journal-title":"Acta Obstet Gynecol Scand"}],"container-title":["BMJ"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/data.bmj.org\/tdm\/10.1136\/bmj.306.6871.182","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmj.306.6871.182","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T06:06:34Z","timestamp":1766383594000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.bmj.com\/lookup\/doi\/10.1136\/bmj.306.6871.182"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1993,1,16]]},"references-count":8,"journal-issue":{"issue":"6871","published-online":{"date-parts":[[1993,1,16]]},"published-print":{"date-parts":[[1993,1,16]]}},"alternative-id":["10.1136\/bmj.306.6871.182"],"URL":"https:\/\/doi.org\/10.1136\/bmj.306.6871.182","relation":{},"ISSN":["0959-8138","1468-5833"],"issn-type":[{"value":"0959-8138","type":"print"},{"value":"1468-5833","type":"electronic"}],"subject":[],"published":{"date-parts":[[1993,1,16]]}}}