BACKGROUND: Advances in understanding the epidemiology of endometriosis have 
lagged behind other diseases because of methodological problems related to 
disease definition and control selection.
AIM: To identify possible risk factors associated with the development of 
endometriosis among a sample of Egyptian women.
MATERIALS AND METHODS: A case-control study was conducted in the University 
Maternity Hospital and some private hospitals in Alexandria. The sample included 
110 cases recently diagnosed with endometriosis and 220 hospital-based, 
age-matched controls.
RESULTS: Using the logistic regression analysis, nulligravidae were four times 
more likely to develop endometriosis than gravid women [adjusted odds ratio 
(AOR)=4.0, 95% confidence interval (CI) (2.2-7.6)]. Short cycles were associated 
with approximately six times increase in risk of endometriosis [AOR=6.1, 95% CI 
(2.9-12.8)]. Women with irregular cycles were three times more likely to develop 
endometriosis than women with regular cycles [AOR=3.5, 95% CI (1.89-6.71)]. 
Similarly, women with a history of irritable bowel syndrome were twice as likely 
to develop endometriosis [AOR=1.9, 95% CI (1.03-3.87)]. Women who had one or 
more relatives with endometriosis were 1.2 times more likely to develop 
endometriosis [AOR=1.2, 95% CI (1.19-1.43)].
CONCLUSION AND RECOMMENDATIONS: Nulliparous and women reporting short and 
irregular cycles were at a significantly increased risk of developing 
endometriosis. A weak association between reported family history of 
endometriosis and history of irritable bowel syndrome and the development of 
endometriosis was also observed. Designing and implementing health education 
programs about endometriosis and its related risk factors should be a priority 
to ensure early diagnosis of the disease.