Women who experience sexual abuse, emotional abuse, neglect, and inconsistency during childhood may be at a higher risk for developing endometriosis, a study suggests.
The study, “Maltreatment during childhood: a risk factor for the development of endometriosis?” was published in the journal Human Reproduction.
Endometriosis is a disease in which the tissue that normally lines the inside of the uterus, called the endometrium, grows outside of the uterus. This causes lesions, which can lead to intense pain and infertility.
It is one of the most common gynecological diseases that affect women in their reproductive years. While researchers have established a few theories that can potentially explain the cause of endometriosis, it is still not clear why some women develop endometriotic lesions while others don’t.
Studies have shown that genetic factors, hormonal issues, and lifestyle factors can contribute to a risk of developing endometriosis.
One contributing factor not often considered for disorders that affect adults is maltreatment during childhood, which can include childhood sexual abuse, physical abuse, emotional abuse and neglect.
Maltreatment during childhood has been associated with a higher incidence of complications and death from chronic diseases such as diabetes or cardiovascular disease. Additionally, studies have shown that maltreatment in childhood is associated with gynecological and obstetrical complications in adulthood.
Moreover, maltreatment during childhood has also been shown to correlate with a chronic inflammatory state, which can contribute to the development of endometriosis. It can also lead to permanent psychological stress (anxiety and depression) in adulthood, which can indirectly influence the development of endometriosis through increased BMI, smoking, alcohol, and caffeine intake.
To determine whether childhood maltreatment contributes to a higher risk for development of endometriosis, researchers designed a multicenter, retrospective study (NCT02511626).
A total of 421 women with endometriosis and 421 healthy controls, matched for age and nationality, were included in the study.
Researchers determined evidence of maltreatment during childhood by analyzing the data collected through the Childhood Trauma Questionnaire (CTQ), given to the participants.
Results suggested that women who experience sexual abuse, emotional abuse, emotional neglect, and inconsistency during childhood are statistically more likely to develop endometriosis later in life. Inconsistency refers to a parent’s lack of perception of the concerns of the child and behavior by parents that results in the child feeling unsafe or a fear that the family may split.
Specifically, results indicated that 20% of women with endometriosis reported a history of sexual abuse compared with 14% of healthy controls, 44% of women with endometriosis reported emotional abuse compared with 28% of controls, 50% of women with endometriosis reported emotional neglect compared with 42% of controls, and 53% of women with endometriosis reported experiencing inconsistency compared with 41% of controls.
Interestingly, rates of other forms of maltreatment during childhood — including physical abuse/neglect, violence against the mother, drug abuse in the family, mentally handicapped family members, suicidal intentions in the family, and family members in prison — were not significantly different between women with endometriosis and the controls.
“Sexual abuse, emotional abuse and neglect, as well as inconsistency experienced in childhood, are associated with a diagnosis of endometriosis,” the authors conclude in the study.
“At present, doctors do not routinely ask women with endometriosis about their childhood experiences. As previous studies have estimated that approximately 20% of children suffer sexual abuse, between 25% and 50% suffer physical abuse, and between 12% to 48% suffer emotional abuse, our findings suggest that doctors should investigate these experiences when taking a patient’s history so that women can receive appropriate treatment as early as possible. This might help to prevent other chronic diseases and mental health problems from developing,” Brigitte Leeners, MD, deputy head of the Department of Reproductive Endocrinology at the University Hospital Zurich and lead author of the study, said in a press release.