Past Issue

Volume 13, Number 3, Oct-Dec 2019 Pages: 230-235

Association between Sexual Activity during Menstruation and Endometriosis: A Case-Control Study

Sanaz Mollazadeh, M.Sc, 1, Behnaz Sadeghzadeh Oskouei, Ph.D, 2, *, Mahin Kamalifard, M.Sc, 2, Mojgan Mirghafourvand, Ph.D, 3, Nayyereh Aminisani, Ph.D, 4, Mehri Jafari Shobeiri, M.D, 5,
Students’ Research Committee, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
Midwifery Department, Tabriz University of Medical Sciences, Tabriz, Iran
Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
Department of Statistics and Epidemiology Faculty of Health Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
Department of Obstetrics and Gynecology, Tabriz University of Medical Sciences, Tabriz, Iran
*Corresponding Address: Midwifery Department Tabriz University of Medical Sciences Tabriz Iran



The prevalence of endometriosis in the general population is estimated at 7-10%. There are various risk factors for this disease, including early menarche age, prolonged menstruation or no history of pregnancy. It seems that sexual activity leading to orgasm during menstruation increases the retrograde menstruation, sending endometrial tissue to an abnormal sites and thus increasing the risk of endometriosis. The present study is aimed to determine the association between sexual activity during menstruation and endometriosis.

Materials and Methods

This case-control study, conducted in the year 2017, recruited 555 women who were visited at Alzahra Hospital in Tabriz, Northwest of Iran. The case group comprised 185 women of reproductive age with confirmed endometriosis. The control group comprised 370 women of reproductive age without endometriosis visit- ing the hospital for other issues. Data was collected using a researcher-made questionnaire based on previous studies. Bivariate analysis was performed by the chi-squared test and multivariate analysis was done using conditional logistic regression to control confounding variables.


The sexual activity of the two groups during menstruation was significantly different. The occurrence of endometriosis in women who stated they had vaginal intercourse or non-coital sexual activities, leading to orgasm during menstruation, was significantly higher compared to those who stated they did not.


According to our findings, there is an association between sexual activities leading to orgasm during menstruation and endometriosis.