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Childhood trauma may increase the risk of endometriosis

Physical abuse and sexual assault may be linked to the development of endometriosis, a recent study shows. – Even those with a low genetic risk may be susceptible to developing the disease if they have experienced significant trauma, says lead author Solveig Løkhammer from the University of Bergen.

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The study is an international collaboration based on previous research that has suggested a possible connection between trauma and endometriosis.Endometriosis is tissue resembling the uterine lining that grows outside the uterus. The condition is very common among women and can cause significant pain and fertility problems for many.

– The motivation for the study was to better understand this potential link between traumatic experiences and the development of endometriosis. Specifically, we wanted to explore whether certain types of trauma were more strongly associated with endometriosis than others, and whether this potential interaction is independent of genetic predisposition, says PhD-candidate and shared first-author Solveig Løkhammer at the University of Bergen. 

Seeking an explanation

Løkhammer is a PhD candidate atthe Department of Clinical Science, University of Bergen. She has collaborated with researchers from Yale, Oxford, and Harvard University in the United States.

The aim of the study has been to uncover new mechanisms that could explain why women develop endometriosis, a condition that is still not well understood. The study examined various types of trauma occuring in childhood and adulthood.

– The results showed that women with endometriosis more frequently reported experiences such as physical and sexual violence, witnessing a sudden death, and receiving a life-threatening diagnosis.

Disrupting hormonal balance 

The traumas ranged from direct physical trauma, such as sexual assault, to more indirect forms, such as emotional trauma or a lack of support from caregivers during childhood.

The researchers cannot yet say for sure what is causing this possible connection. 

– One hypothesis is that trauma may trigger or exacerbate chronic inflammation and disrupt hormonal balance, which could promote the development of endometriosis. Additionally, long-term stress may affect the immune system and pain perception, potentially worsening the symptoms of endometriosis, Løkhammer explains.

The researchers also suggest that neglect and lack of care as a possible explanation, as this may affect how many people seek health care, which in turn can lead to delayed diagnosis and medical treatment.

Not genetically determined

The study also suggests that the relationship between trauma and endometriosis is independent of any genetic risk factors for the condition.

– This implies that even individuals with a low genetic risk for endometriosis could be at risk for developing the disease if they have experienced significant trauma, says Løkhammer. 

– What implications could your findings have for endometriosis patients?

– The study emphasizes the importance of a holistic approach in the future treatment of endometriosis, which is a complex disease with complex needs. The study supports the need for screening programs that include both somatic and mental health, in addition to trauma history. We also hope that increased awareness among healthcare professionals can contribute to earlier diagnosis and more individually tailored treatment of endometriosis, says the UiB researcher.

Link to the study: https://jamanetwork.com/journals/jamapsychiatry/fullarticle/10.1001/jamapsychiatry.2024.4694?guestAccessKey=93003e56-332e-4e73-936a-6e663be0a67c&utm_source=for_the_media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=020525