ABSTRACT
BACKGROUND: Polycystic ovarian syndrome and endometriosis are 2 of the most common reproductive disorders among women but are thought to be unrelated. OBJECTIVE: This study aimed to examine the overlap and common symptoms of polycystic ovarian syndrome and endometriosis. STUDY DESIGN: The study population included the Endometriosis, Natural History, Diagnosis, and Outcomes Study (2007-2009) operative cohort: 473 women, aged 18 to 44 years, who underwent a diagnostic and/or therapeutic laparoscopy or laparotomy at 1 of 14 surgical centers located in Salt Lake City, Utah, or San Francisco, California, in addition to a population cohort composed of 127 women from the surgical centers' catchment areas. Age and site-adjusted multinomial regression models were used to estimate adjusted prevalence ratios and 95% confidence intervals of reproductive history characteristics among women with endometriosis only, women with polycystic ovarian syndrome only, and women with both endometriosis and polycystic ovarian syndrome. RESULTS: Among the operative cohort, 35% had endometriosis only, 9% had polycystic ovarian syndrome only, and 5% had endometriosis and polycystic ovarian syndrome. Among the population cohort, 10% had endometriosis only, 8% had polycystic ovarian syndrome only, and 2% had endometriosis and polycystic ovarian syndrome. In the operative cohort, a history of subfertility was associated with a higher adjusted probability of having both conditions (adjusted prevalence ratio, 10.33; 95% confidence interval, 3.94-27.08), followed by having endometriosis only (adjusted prevalence ratio, 2.45; 95% confidence interval, 1.56-3.84) or polycystic ovarian syndrome only (adjusted prevalence ratio, 1.15; 95% confidence interval, 0.51-2.61), than having neither condition. In addition, experiencing chronic pelvic pain within the past 12 months was associated with a higher probability of having both conditions (adjusted prevalence ratio, 2.53; 95% confidence interval, 1.07-6.00) than having neither condition. CONCLUSION: Among a cohort of women undergoing gynecologic laparoscopy or laparotomy, our study found that nearly 1 in 20 women had both an incident endometriosis diagnosis and symptoms consistent with polycystic ovarian syndrome. Among a population cohort of women not seeking gynecologic care, polycystic ovarian syndrome and endometriosis overlap prevalence was approximately 1 in 50 women.
ABSTRACT
The effect of serpentine soil-like low Ca:Mg ratios on growth was investigated in serpentine-adapted and nonadapted populations of Mimulus guttatus Fischer ex DC through soil and hydroponic reciprocal transplants. Adaptation to Ca:Mg ratios in M. guttatus was measured as differences in biomass accumulation, uptake of Ca and Mg, and photosynthetic rates. Serpentine-adapted plants persisted on both serpentine and nonserpentine soils, but nonadapted plants survived only on nonserpentine soil. When grown hydroponically, a low Ca:Mg ratio decreased the biomass of nonadapted plants but serpentine-adapted plants increased in biomass relative to their growth on high Ca:Mg. Internal concentrations of Ca and Mg mirrored those of the growth solution in both populations; however, serpentine-adapted M. guttatus had a higher shoot:root ratio of Mg when grown in low Ca:Mg solutions. Elevated Mg reduced photosynthetic rates in nonadapted plants without changes in chlorophyll concentration or photosystem efficiency. Hydroponic culture isolated the Ca:Mg ratio from other soil characteristics as the dominant factor affecting growth. Differences in the growth of plants from these populations in reciprocal transplant experiments indicate a genetic basis for a tolerance mechanism to low Ca:Mg, but one that is not based on the exclusion of Mg.
