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Endometriosis Does Not Appear to Increase Bone Fracture Risk

Treatment of disease itself associated with bone loss but not fragility

THURSDAY, Dec. 28 (HealthDay News) -- Although menstrual disorders such as endometriosis have been associated with loss of bone density, women who have the disease are no more likely to sustain fractures than their healthy counterparts, according to a report published in the December issue of Fertility and Sterility.

L. Joseph Melton III, M.D., of the Mayo Clinic in Rochester, Minn., and colleagues analyzed data from Olmsted County, Minn., on 987 women with diagnosed endometriosis who were followed up for 17,408 person-years.

In that time, 256 women sustained 449 fractures, a 20-year cumulative of incidence of 30.8 percent, compared with an expected incidence of 30.6 percent. Age as well as use of steroids and selective estrogen receptor modulators (i.e., tamoxifen or raloxifene) were associated with increased risk of fracture, and women who were physically active were less vulnerable to fractures. Surgery or other treatments for endometriosis had no impact on risk of fracture.

"Despite reports of excessive bone loss among women with endometriosis, as well as fears that GnRH-induced bone loss may not be completely reversible, we found no elevation in the long-term risk of fractures, including the traditional osteoporotic fractures (i.e., hip, spine and wrist) in aggregate," the authors write. "The absence of an adverse effect on overall fracture risk is consistent with other reports indicating that bone density is not compromised in women with endometriosis."

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