Trauma exposures associated with higher endometriosis occurrence in meta-analysis

Researchers searched four databases through October 2, 2026, for observational studies assessing trauma-related exposures and endometriosis. Ten studies involving more than 1.5 million women met the inclusion criteria; six contributed to the random-effects meta-analysis. The review examined variation by diagnostic method, exposure definition, trauma subtype and timing, among other sensitivity analyses.

Trauma-related exposures were associated with higher relative occurrence of endometriosis (pooled estimate 1.32, 95% CI 1.18–1.48; Hartung–Knapp 95% CI 1.12–1.56). Heterogeneity was moderate (I²=58.1%), and the 95% prediction interval was 0.96–1.82. Subgroup estimates varied numerically by diagnosis and exposure definition, but differences were not significant. Analyses of trauma subtype and timing were exploratory and based on few estimates.

The authors caution that the evidence is observational and limited by heterogeneous definitions, retrospective self-report, confounding and diagnostic bias. The association does not establish a causal relationship, and the findings do not support conclusions about routine trauma assessment in endometriosis care. Further prospective studies using standardized exposure measures and diagnostic criteria are needed.