{A figure is presented} Long-term fracture risk among women with proven endometriosis

L. Joseph Melton, Cynthia L. Leibson, Andrew E. Good, Sara J. Achenbach, Ann L Oberg, Sundeep Khosla

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Objective: To determine whether women with pelvic endometriosis are at increased fracture risk. Design: Historical cohort study. Setting: Population-based investigation using the data resources of the Rochester Epidemiology Project. Patient(s): From Olmsted County, Minnesota, 987 women with endometriosis that was first surgically visualized or histologically proven in 1970-1989. Intervention(s): None, observational study. Main Outcome Measure(s): Follow-up for fractures through complete inpatient and outpatient community medical records. Result(s): In 17,408 person-years of follow-up, 256 women experienced 449 different fractures. The cumulative incidence after 20 years (30.8%) was not elevated relative to that expected (30.6%). The independent predictors of any fracture included age (hazard ratio [HR] per 10 years: 1.61; 95% confidence interval [CI] 1.42-1.84]), corticosteroid use (HR: 2.78; 95% CI 1.48-5.24), prior hip, spine, or forearm fracture (HR: 1.82; 95% CI 1.10-3.02), and use of the selective estrogen receptor modulators, tamoxifen or raloxifene (HR: 4.34; 95% CI 2.14-8.81); physical activity was protective (HR: 0.40; 95% CI 0.18-0.88). There was no significant influence on fracture risk of surgery or other medical treatments for endometriosis. Conclusion(s): Despite reported adverse effects of treatment on bone density, there was no overall increase in long-term fracture risk in this unselected cohort of women with proven endometriosis.

Original languageEnglish (US)
Pages (from-to)1576-1583
Number of pages8
JournalFertility and Sterility
Volume86
Issue number6
DOIs
StatePublished - Dec 2006

Fingerprint

Endometriosis
Confidence Intervals
Selective Estrogen Receptor Modulators
Tamoxifen
Forearm
Bone Density
Medical Records
Observational Studies
Hip
Inpatients
Adrenal Cortex Hormones
Epidemiology
Spine
Cohort Studies
Outpatients
Outcome Assessment (Health Care)
Exercise
Incidence
Therapeutics
Population

Keywords

  • Endometriosis
  • epidemiology
  • fracture
  • oophorectomy

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

{A figure is presented} Long-term fracture risk among women with proven endometriosis. / Melton, L. Joseph; Leibson, Cynthia L.; Good, Andrew E.; Achenbach, Sara J.; Oberg, Ann L; Khosla, Sundeep.

In: Fertility and Sterility, Vol. 86, No. 6, 12.2006, p. 1576-1583.

Research output: Contribution to journalArticle

Melton, L. Joseph ; Leibson, Cynthia L. ; Good, Andrew E. ; Achenbach, Sara J. ; Oberg, Ann L ; Khosla, Sundeep. / {A figure is presented} Long-term fracture risk among women with proven endometriosis. In: Fertility and Sterility. 2006 ; Vol. 86, No. 6. pp. 1576-1583.
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abstract = "Objective: To determine whether women with pelvic endometriosis are at increased fracture risk. Design: Historical cohort study. Setting: Population-based investigation using the data resources of the Rochester Epidemiology Project. Patient(s): From Olmsted County, Minnesota, 987 women with endometriosis that was first surgically visualized or histologically proven in 1970-1989. Intervention(s): None, observational study. Main Outcome Measure(s): Follow-up for fractures through complete inpatient and outpatient community medical records. Result(s): In 17,408 person-years of follow-up, 256 women experienced 449 different fractures. The cumulative incidence after 20 years (30.8{\%}) was not elevated relative to that expected (30.6{\%}). The independent predictors of any fracture included age (hazard ratio [HR] per 10 years: 1.61; 95{\%} confidence interval [CI] 1.42-1.84]), corticosteroid use (HR: 2.78; 95{\%} CI 1.48-5.24), prior hip, spine, or forearm fracture (HR: 1.82; 95{\%} CI 1.10-3.02), and use of the selective estrogen receptor modulators, tamoxifen or raloxifene (HR: 4.34; 95{\%} CI 2.14-8.81); physical activity was protective (HR: 0.40; 95{\%} CI 0.18-0.88). There was no significant influence on fracture risk of surgery or other medical treatments for endometriosis. Conclusion(s): Despite reported adverse effects of treatment on bone density, there was no overall increase in long-term fracture risk in this unselected cohort of women with proven endometriosis.",
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