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ten engaged in sexual activity during menstruation. Statistical analysis revealed that women who sometimes or often engaged in sexual activity during menstruation are 1.5 times less likely to have endometriosis than women who do not engage in sexual activities during menstruation. The statistics were roughly the same for women who experienced orgasm during menstruation.

Tampon use appeared to have an even more significant protective effect. Women with endometriosis were less likely to use only tampons during menstruation (11.6 percent) as compared to women without the disease (20.9 percent). About the same number of women in each group reported using both pads and tampons. The number of women with endometriosis who used only pads was 31.3 percent, compared with 22.1 percent for women who do not have the condition. Statistical analysis of these data revealed that women who only used tampons were 2.6 times less likely to have endometriosis compared to women who used pads or pads and tampons.

Kliman said a back up of menstrual fluid in the pelvic cavity is currently believed to play a prominent role in the pathogenesis of endometriosis. As a result, it was hypothesized that tampon use, douching and sexual activity, especially with orgasm, at the time of menstruation would serve to enhance retrograde flow and heighten the chances of developing endometriosis.

"To our surprise, sexual behavior, orgasm and tampon use during menstruation were found to be less frequent among women with endometriosis compared to controls," Kliman said. "It may be that uterine contractions that are part of the female orgasm induces more effective menstrual fluid clearance of the uterine cavity, which in turn may facilitate cervical outflow. Further, the use of tampons may be more efficient at the removal of menstrual fluid compared to the use of pads."

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Contact: Jacqueline Weaver
jacqueline.weaver@yale.edu
203-432-8555
Yale University
29-May-2002

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