Menstrual Characteristics of sub-Sahara Black African Women with and without Endometriosis

One gynecological disorder which is often a mystery to premenopausal women who are affected is endometriosis, a benign condition characterized by ectopic endometrium growing outside the uterus but behaving as if it is still within the uterus.

Hospital records of 226 women who consulted for fertility management at Nordica Fertility Center were surveyed retrospectively. These women were stratified by age into <35 years and >35 years and by BMI into <18.5 (underweight), 18.5-24.9 (normal), 25.0-29.9 (overweight) and >30 (obese). There were 113 who had laparoscopic diagnosis of endometriosis and 113 without endometriosis but just infertility. STATA 13 statistical software was used for analysis of data.

The mean (±sd) age of the women in the study was 34.3 (4.9) with no significant difference among those with (33.9 (4.3)) and without (34.6 (5.4)) endometriosis. There was a significant difference (t=-3.36, P-value=0.0005) in the mean BMI (Kg/m2) of women with endometriosis (25.8±4.9) compared to that of women without endometriosis (27.9±4.5). The probability of endometriosis among normal weight women was higher at age <35 years (OR=2.76, 95% Confidence Interval 1.33,5.73) than at age >35 years (OR=1.59, 95% Confidence Interval 0.62, 4.10). The mean (±SD) parity among those with endometriosis (0.13±0.34) was significantly lower (t-test=2.31; P-value=0.01) than that among women without endometriosis (0.28 ± 0.60). Primary infertility was more prevalent (62.0%) than secondary infertility (38.0%) among those with endometriosis while secondary infertility was more prevalent (55.8%) than primary infertility (44.3%) among those without endometriosis. The mean age (years) at menarche of women without endometriosis (13.3±1.6) was significantly higher (t-test=1.88, P-value=0.03) than that among those with endometriosis (12.9±1). Those with endometriosis were most likely to have dysmenorrhea alone, menorrhagia alone and both dysmenorrhea and menorrhagia concurrently than those without the disease.

Anthropometric and abnormal menstrual profile of patients presenting with pelvic pain, co-morbidity of dysmenorrhea and menorrhagia, infertility and low parity can guide clinicians and gynecologist to make early and proper diagnosis of endometriosis for better treatment outcomes.