Female patients with endometriosis may have a higher risk of experiencing contact trauma, childhood maltreatment, and posttraumatic stress disorder, with adjusted analyses showing significant associations between endometriosis and these trauma-related conditions, according to a recent study.

Investigators led by Dora Koller, PhD, MSc, of the Department of Psychiatry at the Yale School of Medicine, conducted an observational and genetic study to evaluate the association between traumatic experiences and endometriosis, integrating data from multiple large-scale cohorts. In the study, published in JAMA Psychiatry, the investigators analyzed phenotypic and genotypic data from the UK Biobank (incorporating 8,276 patients with endometriosis and 240,117 female controls), a meta-analysis of European (21,779 cases and 449,087 controls) and East Asian (1,713 cases and 1,581 controls) ancestry, and the FinnGen cohort (16,588 cases and 111,583 controls of European descent). Logistic regression, latent class analysis (LCA), genetic correlation, and polygenic risk scoring (PRS) were employed to assess the associations between trauma exposure and endometriosis risk.

Observational analyses found that the patients with endometriosis were significantly more likely to report traumatic experiences compared with controls. Multivariate regression demonstrated associations between endometriosis and contact trauma (odds ratio [OR] = 1.28, 95% confidence interval [CI] = 1.02–1.26), childhood maltreatment (OR = 1.14, 95% CI = 1.02–1.26), and sexual trauma (OR = 1.16, 95% CI = 1.05–1.30). LCA identified four trauma-related latent classes. Endometriosis cases were disproportionately classified into emotional/physical trauma (8% vs 5%, P < 2.2 × 10^–16) and sexual trauma groups (5% vs 4%, P = 2.9 × 10^–3), while controls were more likely to belong to the no trauma group (20% vs 24%, P = 7.4 × 10^–14).

Genetic correlation analyses found pleiotropic relationships between endometriosis and trauma-related conditions, including posttraumatic stress disorder (meta-analysis genetic correlation [rg] = 0.31, P = 7.1 × 10^–16; FinnGen rg = 0.26, P = 4.7 × 10^–15) and childhood maltreatment (meta-analysis rg = 0.23, P = 1.3 × 10^–6; FinnGen rg = 0.16, P = 1 × 10^–4). PRS analysis found that participants in the top 25% of endometriosis genetic risk had 2.32-fold higher odds (95% CI = 2.15–2.51) of developing the disease compared with the bottom 25% (P < 2.2 × 10^–16). However, no statistically significant interaction was observed between PRS and trauma types, suggesting that genetic predisposition and trauma exposure independently contributed to endometriosis risk. The findings indicated that trauma exposure and genetic predisposition were independently associated with endometriosis, with no statistically significant interaction observed between genetic risk scores and trauma types.

Full disclosures can be found in the published study.