Mental health
Childhood trauma linked to higher risk of endometriosis, study finds

Women who experience trauma or hardship in childhood may have up to twice the risk of developing endometriosis later in life, new research has found.
A study involving more than 1.3 million women found those exposed to violence in childhood were over twice as likely to be diagnosed with the condition compared to those who were not.
The risk of endometriosis was 20 per cent higher in women who experienced any form of childhood adversity and rose to 60 per cent among those with five or more adverse experiences.
The research, conducted in Sweden, analysed data from women born between 1974 and 2001. More than 24,000 of them had received a diagnosis of endometriosis.
Researchers used national health and social records to examine childhood circumstances.
Factors included having parents with mental illness, intellectual disability, financial hardship or substance misuse, being born to a teenage parent, experiencing bereavement, or being exposed to violence or sexual abuse.
All factors studied—except bereavement—were linked to an increased risk of developing endometriosis in later life.
Marika Rostvall is first author of the study and a physician and doctoral student at the Department of Global Public Health at Karolinska Institutet.
The researcher said: “We also saw that the more adverse experiences in childhood, the higher the risk. Among those who had five or more factors, the risk increased to 60 per cent.”
The most significant increase was seen in women who had been exposed to violence, who had more than double the risk of being diagnosed with endometriosis.
Rostvall said: “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.
“The findings are also in line with previous research showing that difficulties in childhood have profound consequences for future health.”
While the biological mechanism is not yet fully understood, Rostvall suggested two possible explanations.
One is that stress during childhood may impair immune system function, reducing its ability to remove endometrial tissue from the body.
Another is that trauma could increase sensitivity to pain, making symptoms more likely to be noticed and diagnosed.
Rostvall said: “I hope that the findings can be used to improve both preventive measures and treatment in healthcare,” she added.
As the study is observational, it does not establish a direct cause-and-effect relationship.
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Menopause
CBT shows promise for menopause insomnia and hot flashes

Cognitive behavioural therapy (CBT) may offer short-term relief for menopause insomnia and night-time hot flushes, a pilot study suggests.
CBT is a structured, short-term talking treatment that helps people change thoughts and behaviours that can worsen sleep problems.
Researchers found the intervention was linked to meaningful short-term improvements in insomnia severity, hot flush interference, sleep self-efficacy, or confidence around sleep, and depressive symptoms.
The Menopause Society said insomnia affects an estimated 20 to 60 per cent of perimenopausal and postmenopausal women in the US.
Ongoing research is focusing on effective treatments because insomnia can have serious physical and psychological effects.
Dr Monica Christmas, associate medical director for The Menopause Society, said: “Nocturnal hot flushes (night sweats) and sleep disruption can have a significant effect on the quality of life with many women claiming extreme impairment due to symptoms that often start in early perimenopause and last 10 or more years.”
“Sleep disturbances can persist even in those using pharmacological therapy to manage hot flushes.
“The study’s findings highlight the utility of cognitive-behavioural therapy as a standalone treatment for insomnia and hot flushes, offering women an alternative or adjunct to pharmacological treatments.”
Insomnia is defined as disturbed sleep associated with distress or impaired daily functioning and is one of the most common complaints in perimenopause and postmenopause.
It can reduce quality of life and is linked to higher healthcare use and costs, disability, depression and cardiovascular disease.
Hot flushes occur in 60 to 80 per cent of women during the menopause transition and can persist for four to five years on average.
Night-time hot flushes are linked to sleep disruption, and women may respond by napping or spending longer in bed, which can help keep insomnia going.
Previous studies have shown that cognitive behavioural therapy is an effective treatment for insomnia and may also help women cope with hot flushes and other menopause symptoms.
However, few trials have looked at both insomnia and hot flushes together.
Insomnia during and after the menopause transition is complex and can have many causes, including ageing, hormone fluctuation, hot flushes, other sleep disorders, psychiatric and medical conditions and psychosocial stressors.
Because women with acute and sustained insomnia can experience greater negative health effects, effective treatment is important.
The pilot study concluded that CBT was feasible and may be a promising approach for menopause-related insomnia and nocturnal hot flushes, although the benefits appeared to lessen after three months.
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