Sunday, December 12, 2010

Fibroids more common after child abuse

Medline Plus
Monday, November 29, 2010
By Alison McCook

NEW YORK (Reuters Health) - Women who were abused as children are more likely to develop uterine fibroids as adults, a new study finds.

The results suggest that the consequences of child abuse can last way beyond childhood, study author Dr. Renee Boynton-Jarrett of the Boston University School of Medicine told Reuters Health.

"Childhood abuse is something that happens in childhood, but this experience could jeopardize your health in adulthood, as well."

The report, published in the journal Epidemiology, also showed that the more abuse women said they suffered as children, the more likely they were to be diagnosed in adulthood with fibroids, which can cause pain, abnormal bleeding and infertility.

The study cannot prove that child abuse caused women's fibroids, but there are several reasons why early abuse might increase fibroid risk, Boynton-Jarrett explained. "One possibility is that childhood abuse is associated with health behaviors such as eating and activity patterns, which elevates your risk of obesity," a known risk factor for fibroids.

Alternatively, chronic stress resulting from the abuse may disrupt how the body regulates hormones, which can also raise the risk of fibroids, Boynton-Jarrett added.

Encouragingly, among women who were abused, those who received more emotional support as children were somewhat less likely to develop fibroids, suggesting that it's possible to mitigate the negative effects of abuse. "We might not be able to prevent every episode of child abuse," Boynton-Jarrett said, but "we can support those children differently," by providing them with extra social support, a step that "might have long-term benefits."

According to Childhelp, every 10 seconds, a person reports a case of child abuse. Previous research has shown that people abused as children tend to have more health problems as adults.

Uterine fibroids are generally benign tumors that grow in the walls of the uterus. They can be removed by minimally invasive surgery.

Up to 1 in 4 women will develop symptoms from fibroids at some point in their lives.

To investigate whether the condition is more common among women with a history of abuse, Boynton-Jarrett and her team reviewed data collected from 60,615 women about their exposure to violence, and followed them for 16 years, noting who developed fibroids.

Sixty-five percent of participants said they had been physically or sexually abused as children or teenagers, and nearly 10,000 were eventually diagnosed with fibroids.

Among those who developed fibroids, nearly 70 percent reported some history of abuse. Relative to women with no history of abuse, women who said they had been abused as children were between 8 and 36 percent more likely to develop fibroids, with the risk of fibroids increasing the greater a woman's exposure to severe, chronic or multiple types of abuse.

The study is "very well done," Dr. Jackie Campbell at Johns Hopkins University School of Nursing, who did not participate in the research, told Reuters Health. "It gives us important direction for future research."
Campbell herself has found that African-American women who were abused by an intimate partner were also at higher risk of fibroids, and for that reason, she said she wishes the study had looked separately at the effect of intimate partner violence on adults.

Based on these findings, it makes sense for gynecologists to "routinely" screen women for a history of abuse, or the presence of abuse by an intimate partner, given the potential long-term effects on their health, Campbell concluded.

SOURCE: Epidemiology, online November 9, 2010.
Reuters Health
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