Impact of family history for endometriosis, migraine, depression and early menopause on endometriosis symptoms, localization and stage: A case control study

• Published in: European journal of obstetrics & gynecology and reproductive biology 2024-02, Vol.293, p.36-43
• Main Authors: Metzler, Julian Matthias, Imesch, Patrick, Dietrich, Hanna, Knobel, Chiara, Portmann, Lea, Neumeier, Maria S., Merki-Feld, Gabriele Susanne
• Format: Article
• Language: English
• Subjects: Depression; Early menopause; Endometriosis; Family history; Migraine
• ISSN: 0301-2115; 1872-7654
• DOI: 10.1016/j.ejogrb.2023.12.016

•Around 30% of endometriosis patients report a family history of migraine or depression.•Endometriosis patients with positive family histories differ in disease characteristics.•A family history for endometriosis is associated with higher rASRM scores and more endometriomas.•Endo patients with a family history for depression respond better to combined contraceptives. Endometriosis is a common disabling pain condition in women of childbearing age, frequently showing familial clustering. Nevertheless, little is known about whether familial predispositions influence its severity or presentation. In this study, we investigate disease characteristics in endometriosis patients with a family history (FH) for endometriosis or the comorbidities migraine, depression and early menopause (EMP). We performed an observational case-control study enrolling women with histologically confirmed endometriosis in a tertiary center. Based on surgical findings, patient records and phone interviews, we examined the relations between a FH for endometriosis, migraine, depression or EMP and endometriotic signs and symptoms, such as response to combined hormonal contraceptives (CHC) and analgesics, disease localization, infiltration depth, Enzian- and rASRM-scores. A positive FH for endometriosis, migraine, depression or EMP was reported by 10.2 %, 33.4 %, 32.6 % and 9.9 % of the 344 patients. A positive FH of endometriosis was associated with an increased risk for high rASRM-scores (rASRM 3 + 4: OR 2.74 (95 % CI 1.16–6.49), p = 0.017) and the presence of endometriomas (OR 2.70 (1.22–5.95), p = 0.011). A positive FH for migraine was associated with less response of endometriosis symptoms to CHC (OR 0.469 (0.27–0.82) p = 0.025). Depression in the family was linked to less severe rASRM-scores (rASRM 3 + 4: OR 0.63 (0.39–0.99), p = 0.046) and less endometriomas (OR 0.58 (0.67–0.92), p = 0.02), but increased the risk of both migraine (OR 1.66 (1.01–2.73), p = 0.043) and depression (OR 3.04 (1.89–4.89), p