DOES CONTRACEPTION MODIFY THE RISK OF ENDOMETRIOSIS

Long episodes of regular, prolonged, abundant menstrual flows are gene rally agreed to increase the risk of endometriosis. Since oral oestrog en-progestogen combinations reduce and intra-uterine contraceptive dev ices increase menstrual flow, an effect on the risk of development of endometriosis in women utilizing these forms of contraception could be expected. Analysis of the most recent epidemiological observations sh ows no consensus on a possible relationship between use of cyclic oral contraceptives and endometriosis, with an increase, a decrease, and n o effect on the risk of developing the disease all being reported. A l ower relative risk of endometriosis in previous users of the intrauter ine contraceptive device was only found in two series, most of the oth er data suggesting a rise in risk or no effect. Further studies on the relationship between type of contraception and endometriosis are need ed to demonstrate whether the risk of development of the disease could be influenced, and whether well tolerated, relatively inexpensive, lo ng-term treatment might be available for symptomatic patients not desi ring offspring.