A Study Of The Relationship Between Women's Emotion, Living Habits, Menstrual Situation, History Of Pregnancy And Birth And Endometriosis

BackgroundEndometriosis (EMT for short) is a common disease of obstetrics and gynecology, and is one of the reasons which caused pelvic pain and infertility in childbearing age women. The Western medicine pathogenesis of endometriosis is uncertain currently, and history of previous surgery, menstrual disorders, habits during periods, bad living habits, menstrual exercises, psychological factors etc. might be the disease-related risk factors. Lparoscopy is the standard mean for endometriosis diagnosis. However, because of it is invasive and costs high price, medical community is looking for non-invasive diagnostic method.ObjectiveThe purpose of this study was to further improve the pathogenesis of endometriosis-related factors, explore the relationship between endometriosis and psychological factors, living habits, menstruation, pregnancy history as well as all kind of clinical symptoms of women. And hope that by the way of filling questionnaire, developed a non-invasive diagnosis method of endometriosis. To shorten or reduce diagnosis delays of endometriosis, and to provide a healthy lifestyle to prevent or reduce the incidence of endometriosis.MethodTo recruit in-patients who were going to take laparoscopic surgery from November 2008-December 2009 in Gynecological Department of Guangdong Provincial Hospital of TCM, and asked the patients to fill survey questionnaire. After the laparoscopic surgery they were divided into two groups, endometriosis group and non-endometriosis group. We studied the differences between two groups in their quality of life, menstruation, contraceptive history, menstrual hygiene products, pelvic pain, pregnancy and births history, infertility history, surgical history, previous history, living habits, allergic history and so on, to investigate endometriosis-related risk factors.Result1. In this study we recruited 301 patients, of which 294 cases completed the questionnaire and surgical records,7 cases of incomplete questionnaire or surgery were withdrew from the study.2. Quality of life statistics showed that endometriosis patients had a lower scores in body pain than non-endometriosis patients, but not lower than non-endometriosis patients in the other indexes of life quality. Endometriosis patients even had higher scores in emotional function and mental health than non-endometriosis patients.3. Univariate analysis showed that patients with endometriosis had a higher percentage of "feel happy" than non-endometriosis patients, the difference was statistically significant. Endometriosis patients had longer and heavier period as well as shorter menstrual cycle than non-endometriosis patients. The percentage of dysmenorrheal and defecation pain were higher in endometriosis patients. On the other hand, patients with endometriosis had lower proportion in sexual intercourse during menstruation, infertility, history of uterine surgery than patients without endometriosis. In addition, patients with endometriosis had higher proportion in history of ovarian cysts, and likely to have higher education than those without endometriosis. Results also showed that endometriosis patients were taller and thinner than non-endometriosis patients.4. Multivariate analysis showed that consider to take surgery due to menstrual pain or ovarian tumor, heavy period, dysmenorrheal, ovarian cysts history were endometriosis-related risk factors. While extended menstrual cycle, sexual intercourse during menstruation and history of uterine surgery seemed to be protective factors of endometriosis.5. Research statistics showed that the most common TCM syndrome of endometriosis is Qi and blood stagnation type, followed by deficiency of kidney and blood stagnation. Age and the number of excess syndrome were directly proportional but age and the number of excess and deficiency mixed syndrome were contrary. The operation phases of endometriosis showed no significant correlation with TCM syndrome classification. Conclusion1. This study suggests that endometriosis-related risk factors include: consider surgery due to menstrual pain or ovarian tumor, heavy period, dysmenorrheal and history of ovarian cysts, extended menstrual cycle was considered as a protective factor of endometriosis.2. Since this study did not have a normal control group, although Multivariate analysis showed that sexual intercourse during menstruation and history of uterine surgery seemed to be protective factors of endometriosis, this conclusion was still not established.3. The relationship between endometriosis and emotional factors, menstrual hygiene, history of pregnancy and birth, history of infertility, previous history, personal history, family history had not yet revealed in this study. We need further study.