{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 journalArticlepeer-review

2 Scopus citations


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
Issue number6
StatePublished - Dec 2006


  • Endometriosis
  • epidemiology
  • fracture
  • oophorectomy

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology


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