The cause is not completely understood, but the changes are believed to be associated with ovarian hormones since the condition usually subsides with menopause, and may vary in consistency during the menstrual cycle. The incidence of it is estimated to be over 60% of all women. It is common in women between the ages of 30 and 50, and rare in postmenopausal women. The incidence is lower in women taking birth control pills. The risk factors may include family history and diet (such as excessive dietary fat, and caffeine intake), although these are controversial.
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