Periodontal disease and endometriosis: analysis of the National Health and Nutrition Examination Survey

Objective: To investigate whether an association exists between endometriosis and periodontal disease, because endometriosis and periodontal disease are chronic, inflammatory processes more common in patients with systemic autoimmune disorders and because each disease alters immune modulators. Design: Cross-sectional study. Setting: University health system and statistical center. Patient(s): Data for 4136 women, ages 18-50, in the National Health and Nutrition Examination Survey, 1999-2004. Intervention(s): None. Main Outcome Measure(s): Periodontitis and gingivitis among those patients with and without self-reported endometriosis. Result(s): Multinomial logistic regression showed that women with self-reported endometriosis had significantly (57%) higher odds of having both gingivitis and periodontitis relative to not having periodontal disease, compared with women without self-reported endometriosis (adjusted odds ratio, 1.57; 95% confidence interval, 1.06, 2.33), when controlling for other relevant factors. Conclusion(s): The results of this study suggest a possible association between endometriosis and periodontal disease. Although it is conceivable that the multifactorial development of endometriosis may be augmented by an immune response to an infectious agent, the potential underlying link between endometriosis and periodontal disease may be a generalized, global immune dysregulation. (Fertil Steril (R) 2009;91:335-42. (C)2009 by American Society for Reproductive Medicine.)