Effects of Endometriosis on Bone Mineral Density
Condition: Endometriosis
MeSH terms: Endometriosis
Study type: Observational

Summary: 
      This study will compare bone mass in women with a history of endometriosis, a disease in
      which the lining of the uterus grows on nearby tissues, to that of women who have not had
      endometriosis. Endometriosis may be treated with medication or surgery, or both. Because
      uterine tissue grows more when estrogen levels are high, medical treatment is designed to
      lower estrogen. Decreased estrogen, however, is often associated with weak bones and hot
      flashes. Also, women with endometriosis may have lower bone density as a consequence of their
      disease. This study will look at bone density in these women, particularly to see if areas
      other than the lower back may be affected.

      Regularly menstruating women between 40 and 50 years old, with or without a history of
      endometriosis, may be eligible for this study. Candidates are screened by telephone; women
      with endometriosis are asked to provide documentation of their endometriosis before beginning
      the study.

      Study participants undergo the following tests and procedures:

        -  Medical history and blood sample collection

        -  Questionnaires about exercise activity, calcium intake, menstrual cycle history,
           cigarette use and medication history

        -  DEXA scan: This test evaluates the strength of the bones in the back, wrist, and hip.
           The DEXA scanner uses low-energy x-rays to determine bone density. Scans are done of the
           lower spine, upper thigh, hip, and the entire body. For the test, the subject lies on
           the scanning table. Each scan takes about 3 minutes, and the entire procedure may take
           as long as 1 hour.
    

Detailed description: 
      After peaking in the third decade, bone mineral density (BMD) decreases slowly over time,
      with a more dramatic short-term decline at the time of menopause. Because of the association
      with osteoporosis and fracture, evaluation of BMD at the time of menopause is recommended, as
      is identification and treatment of any reversible causes of bone mineral loss. Most studies
      of women with endometriosis have shown no change or decreased BMD, while rats with induced
      endometriosis had a marked decrease in BMD. Often, studies in women did not control for
      factors that are known to affect bone density such as body mass index (BMI), exercise, or
      calcium intake. To address the question of whether endometriosis is associated with a change
      in BMD, we previously matched healthy volunteers and endometriosis patients for age, race,
      BMI, exercise level and calcium intake and compared BMD in the two groups. We found a
      decrease in BMD in women aged 40 - 50 who had a history of endometriosis, in comparison to
      women who did not have such a history. This study will expand that experience by studying
      more women aged 40 - 50 years with a history of endometriosis and matching them to women of
      the same race with similar age and BMI, who do not have a history of endometriosis.
      Participants will fill out a questionnaire about their medical, exercise and dietary history
      and will provide a single blood sample. A bone density study will be done and results will be
      made available to the participants.
    

Keywords: Endometriosis; Bone Mineral Density; Osteopenia; Osteoporosis; DEXA Scan; Menopause; Screening; Healthy Volunteer; HV