Endometriosis is a chronic, inflammatory disorder characterized by the abnormal growth of tissue similar to the endometrium outside the uterus. It affects a stunning 10% to 15% of individuals of reproductive age worldwide, totaling approximately 190 million women. This painful condition often leads to debilitating pelvic pain, especially during menstruation and sexual intercourse, along with complications like infertility and digestive issues.

Despite its widespread impact, a definitive cause for endometriosis has eluded researchers for years. However, new research published in JAMA Psychiatry in February 2025 sheds light on the potential links between traumatic experiences, genetics, and the risk of developing this painful disease.

The study analyzed clinical and genetic data from nearly 250,000 female participants in the UK Biobank, which included over 8,000 diagnosed with endometriosis. By incorporating genetic information from the FinnGen Project and other studies, the research encompassed data from over 500,000 women, revealing that trauma and genetics independently contribute to endometriosis risk.

Unmasking the Types of Trauma

Investigators found that women suffering from endometriosis reported significantly higher instances of traumatic experiences, including sexual assault, life-threatening diagnoses, and witnessing sudden deaths. In fact, categories of trauma showed that those with endometriosis had increased exposure to contact trauma, childhood maltreatment, and various other stress-inducing events.

Researchers observed that about 8% of women with endometriosis were classified under emotional/physical trauma, compared to 5% of their counterparts without the condition. Moreover, 5% of women with endometriosis reported experiencing sexual trauma, while only 4% of the control group reported the same.

The Genetic Connection to PTSD

Interestingly, endometriosis has been genetically linked to disorders like post-traumatic stress disorder (PTSD) and childhood maltreatment, suggesting that mental health factors could be significant contributors to the disease’s complexity. This research indicates that both genetic predispositions and traumatic experiences can exacerbate the likelihood of developing endometriosis in separate but potentially cumulative ways.

Why Trauma Matters for Physical Health

The systemic nature of endometriosis implies that it affects various biological systems beyond just reproductive health. Recent studies indicate a correlation between trauma and multiple health issues, including cancer and cardiovascular diseases.

Chronic stress from traumatic experiences may trigger inflammatory responses in the body, contributing to the development of endometriosis. Additionally, trauma can disrupt hormonal balance, particularly raising cortisol levels, potentially worsening symptoms or influencing the disease's progression through its impact on estrogen.

Furthermore, trauma can lead to long-lasting changes in epigenetics, which regulate immune responses and hormonal functions, thereby complicating the clinical picture of endometriosis.

Implementing Trauma-Informed Care

This research emphasizes the necessity of evaluating both physical and mental health in individuals with endometriosis. Trauma-informed care becomes essential in providing holistic treatment to patients. This healthcare approach recognizes the profound effects that past traumas have and creates a supportive and safe environment for patients during their medical interactions—especially in sensitive fields like gynecology.

For those with a history of trauma, gynecological exams can be particularly distressing, possibly deterring them from seeking vital care. The disparity in timely diagnoses is alarming, as individuals can experience a delay of 4 to 11 years before receiving effective treatment for endometriosis.

As this groundbreaking study highlights the multifaceted connections between trauma and endometriosis, it paves the way for further understanding of how mental health factors play a critical role in this troubling condition. The findings not only provide insight into potential treatment avenues but also underscore the urgent need for a compassionate approach to care in gynecological settings.