Article Impact Level: HIGH Data Quality: STRONG Summary of JAMA Psychiatry. https://doi.org/10.1001/jamapsychiatry.2024.4694 Dr. Dora Koller et al.
Points
- Women with endometriosis were more likely to report childhood and adulthood traumatic experiences, including emotional, physical, and sexual trauma.
- Individuals with endometriosis had a higher likelihood of contact trauma (OR 1.28, 95% CI 1.02–1.56) and a strong association with emotional and physical trauma (P < 2.2 × 10^−16).
- Genetic analyses showed a significant correlation between endometriosis and PTSD (rg = 0.31, P = 7.1 × 10^−16) and childhood maltreatment (rg = 0.23, P = 1.3 × 10^−6).
- While polygenic risk scores (PRS) were linked to endometriosis (β = 0.31, P < 2.2 × 10^−16), no direct interaction was found between genetic predisposition and trauma exposure.
- The study highlights the need to consider trauma history alongside genetic factors in understanding endometriosis and calls for further research on mechanisms linking trauma to disease development.
Summary
This case-control study investigated the association between traumatic experiences and endometriosis, combining phenotypic and genetic data from the UK Biobank, large meta-analyses, and the FinnGen cohort. The study included 8,276 women with endometriosis and 240,117 female controls. The results revealed that women with endometriosis were more likely to report both childhood and adulthood traumatic experiences, including emotional, physical, and sexual traumas. Notably, individuals with endometriosis had a higher likelihood of contact trauma (odds ratio [OR] 1.28, 95% CI 1.02–1.56) and a more significant association with emotional and physical trauma (P < 2.2 × 10^−16). Genetic analyses also indicated a pleiotropic relationship between endometriosis and trauma-related outcomes, particularly posttraumatic stress disorder (PTSD) and childhood maltreatment.
Latent class analysis (LCA) highlighted a strong association between endometriosis and emotional (P < 2.2 × 10^−16) and sexual trauma (P = 2.9 × 10^−3), with a significant difference in the distribution of trauma exposure between endometriosis cases and controls. The genetic correlation (rg) between endometriosis and PTSD was substantial, with meta-analysis rg = 0.31 (P = 7.1 × 10^−16), and the correlation with childhood maltreatment was also notable (rg = 0.23, P = 1.3 × 10^−6). Polygenic risk scores (PRS) for endometriosis were associated with an increased likelihood of the disease (β = 0.31, P < 2.2 × 10^−16), yet no direct interaction was found between the genetic predisposition and specific types of trauma.
This study suggests that traumatic experiences, particularly those involving physical contact, may be independently associated with the development of endometriosis. These findings underscore the need to consider both genetic predisposition and the impact of trauma in understanding the pathogenesis of endometriosis. Future research should focus on elucidating the mechanisms linking trauma and endometriosis to inform prevention and therapeutic strategies.
Link to the article: https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2829592
References Koller, D., Løkhammer, S., Goroshchuk, O., Denner, V., Stiltner, B., Mitjans, M., He, J., Taylor, H. S., Lawn, R. B., Koenen, K. C., & Polimanti, R. (2025). Observational and genetic analyses of traumatic experiences and endometriosis. JAMA Psychiatry. https://doi.org/10.1001/jamapsychiatry.2024.4694
