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Trauma, Endometriosis, and Fertility – Are They Linked?

Endometriosis is a painful condition in which tissue similar to the lining of the uterus grows outside the uterus, in places where it doesn’t belong. The tissue may swell and bleed like the uterine lining does every month, causing swelling and pain because it’s in an area where it can’t easily get out of the body. Endometriosis affects nearly 10 percent of women aged 15-44 globally. The exact causes of the condition have not yet been defined.

Childhood Trauma and Endometriosis

Child abuse and neglect, unfortunately, are common.  In the U.S., at least 1 in 7 children (more than 14 percent) experience child abuse and neglect annually, and this is likely an understatement because many cases are not reported. Recent research points to a connection between childhood trauma and endometriosis.  A survey of more than 60,000 premenopausal women with endometriosis found that 31 percent reported experiencing some form of physical abuse as children.  While 12 percent reported some form of sexual abuse, 21 percent reported both types of abuse. The researchers found that for women who had been through chronic or severe abuse their risk of being diagnosed with endometriosis (as confirmed in surgery) was 79 percent higher than the risk of women who had not been abused. The researchers caution that the findings do not mean that all women who have endometriosis were abused as children, or that all women who experience abuse will develop endometriosis. Childhood maltreatment has been linked to a wide range of physical health problems in adulthood.  More research is needed to understand the relationship between trauma and its physiological effects on the body. Stress has not been proven to cause infertility, but chronic stress may play a role in making it harder to conceive.  It may be that chronic stress from PTSD due to childhood abuse can be another potential link between trauma and fertility issues.

Endometriosis and Fertility

Many women with endometriosis do eventually get pregnant and have children, but it may be harder for them to conceive. Research has found that as many as one in two women who struggle with fertility have endometriosis.  It’s not clear how endometriosis might cause fertility issues, but potential reasons involve the tissues blocking or scarring fallopian tubes, changing the shape of the uterus and other reproductive organs so they are less conducive to uniting the egg and sperm, or the immune system attacking the embryo. Treatment has evolved in recent years, and laparoscopic surgery is not chosen as often as it was in the 20th century. A fertility specialist may prescribe a gonadotropin-releasing hormone (GnRH) agonist, which puts the patient into temporary menopause and helps control the growth of endometriosis. Once the patient stops taking the medicine and their periods return, they may have a better chance of getting pregnant. IVF is frequently used with patients who have endometriosis, avoiding any issues with fallopian tube blockage or scar tissue in the uterus. Fertility patients with endometriosis require specialized support, both medically and emotionally.  “WINFertility has an amazing community that can offer not only medical knowledge, but emotional and psychological support as well. Our behavioral health team can be a wonderful support system for couples looking to build their families,” says Leslie, a WIN Nurse Care Manager.

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