Childhood Trauma May Increase Endometriosis Risk

Endometriosis is a common but poorly understood condition affecting millions of women. A new large-scale study conducted in Sweden shows that difficult childhood experiences increase the risk of being diagnosed with endometriosis later in life.

The research, published in Human Reproduction, highlights the lasting impact of childhood stress on women’s reproductive health.

Can childhood hardship raise endometriosis risk?

Endometriosis affects ~1 in 10 women of reproductive age worldwide. It occurs when tissue similar to the uterine lining ends up outside the uterus. These lesions can cause chronic pelvic pain, inflammation, scarring and in some cases, infertility.

Despite its prevalence, we still don’t fully understand what causes it.

Researchers have looked at genetic, hormonal and immune system factors in the past, however, there is also growing interest in investigating whether stress or trauma might play a role.

A connection between childhood hardships and long-term health has been seen in chronic pain and immune issues.

“A few studies have previously demonstrated an association between self-reported childhood abuse and an increased risk of endometriosis,” said the authors.

One cohort study reported that women who experienced severe, ongoing abuse had a 79 % higher risk of confirmed endometriosis. However, these studies are mostly limited and often rely on self-reported data.

Few large-scale studies have tested whether a range of childhood adversities is tied to later endometriosis.

The new Swedish study tracked over 1.3 million women, using register data to look at adversities including parental mental illness, financial strain, teenage parenthood, violence and abuse – asking the question: Do these early troubles raise the odds of endometriosis?

Tracking childhood stressors in endometriosis research

The study followed women born in Sweden between 1974 and 2001. Using linked national registers, the researchers pulled in data on healthcare, education and social services. Just over 24,000 women in the group had been diagnosed with endometriosis.

The researchers looked at whether these women had been exposed to any of several childhood adversities. These included growing up with a parent who had a mental illness, substance use disorder or intellectual disability, having a teenage parent, household financial problems, being exposed to or experiencing violence or sexual abuse and the death of a close family member.

Using a retrospective cohort design, the team tracked how these early-life stressors related to endometriosis diagnoses later on, adjusting for factors such as birth year, parental education and place of residence to reduce bias.

Women who experienced at least one form of adversity had a 20% higher risk of being diagnosed with endometriosis. The risk went up with the number of adverse experiences.

“We also saw that the more adverse experiences in childhood, the higher the risk. Among those who had 5 or more factors, the risk increased to 60%,” said lead author Marika Rostvall, a physician and doctoral student at the Department of Global Public Health at Karolinska Institutet.

The strongest association was for exposure to violence. These women were more than twice as likely to be diagnosed with endometriosis.

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The only factor that didn’t show a significant link was the death of a family member.

Mental health's role in endometriosis care

The findings back up a growing body of evidence: what happens in childhood can shape health decades later. In this case, early adversity might raise the risk of endometriosis by affecting how the body handles inflammation or responds to pain.

“The results suggest that early life experiences can affect the body's health much later in life and highlight the importance of looking at the whole person, not just the symptoms,” said Rostvall.

She pointed to two possible reasons for the link. “One explanation is that stress during childhood can affect the immune system, which could prevent it from effectively eliminating endometriosis tissue. Another explanation is that trauma during childhood could affect the body's sensitivity to pain, which can lead to increased pain and thus a higher likelihood of being diagnosed with endometriosis.”

This kind of evidence could shift how clinicians approach endometriosis. Psychosocial history may become more relevant in diagnosis and care. It could also support more integrated treatment options that include mental health support or trauma-informed care.

Future studies should explore biological pathways linking stress to endometrial growth or test whether reducing early life stress helps lower gynecological risk later on.

“I hope that the findings can be used to improve both preventive measures and treatment in healthcare,” said Rostvall.

Reference: Rostvall M, Magnusson C, Gemzell-Danielsson K, Kosidou K, Sieurin J. Adverse childhood experiences and the risk of endometriosis—a nationwide cohort study. Hum Reprod. 2025. doi: 10.1093/humrep/deaf101

This article is a rework of a press release issued by the Karolinska Institutet. Material has been edited for length and content.