Childhood adversity and risk of endometriosis, fibroids, and polycystic ovary syndrome: a systematic review.

Importance: Although childhood adversity has been extensively studied in relation to various health outcomes, investigation of its association with gynecological conditions remains limited.

Objective: To systematically review studies examining the effect of childhood adversity on the prevalence of three gynecological conditions: endometriosis; fibroids; and polycystic ovary syndrome (PCOS) in the population.

Evidence review: Six databases were searched from inception to March 12, 2024. Observational studies of women with exposure to adversity before the age of 18 and an outcome of endometriosis, fibroids, and/or PCOS were eligible for inclusion. Studies were summarized through a qualitative synthesis. We evaluated the risk of bias using the Newcastle-Ottawa Scale.

Findings: Seven studies that reported on the association between a form of childhood adversity and endometriosis, fibroids, and or PCOS were selected for review. All seven studies received a moderate risk of bias score. Cumulative exposure to childhood adversity was associated with an increased risk of endometriosis and fibroids. Childhood exposure to sexual abuse was associated with an increased risk of endometriosis and fibroids. Exposure to physical abuse in childhood was associated with a greater risk of fibroids.

Conclusion and relevance: A small number of studies have shown an association between childhood adversity and the development of endometriosis and fibroids in later life. These initial findings warrant further investigation in larger studies using standardized measures.