Scientists have discovered that women with a record of severe acne in their adolescence are at considerably increased risk of endometriosis. (Dr. Jing Xie of Harvard Medical School in Boston)
We should therefore consider early referral for patients with a history of severe teenage acne and non-specific symptoms, such as an irregular menstrual cycle or abdominal pain and gynaecologists should consider surgical intervention earlier in these patients than would otherwise be warranted.
“Because this is a very obvious indicator, you can easily observe it, it may actually improve diagnosis, and may be used in screening,” he said.
You may be aware that current New Zealand statistics are that it takes an average of 6.9 years from first presentation to a GP to diagnosis of endometriosis and that this increases to 9.5 years for women who first present under the age 20 but decreases to just 4 years for women with infertility.
“A single nucleotide polymorphism on chromosome 8q24 was recently linked to a four-fold increased risk of severe teenage acne, while several studies have found altered expression of the c-myc gene — also located at chromosome 8q24 — in endometriosis, the researchers note.”
The authors conducted a prospective cohort study using data from the Nurses Health Study II, which included 88,623 women followed from September 1989 to June 2009.
During follow-up, there were 4,382 new (7.9% of the group), laparoscopically confirmed cases of endometriosis among the study participants. Women who reported a history of severe teenage acne were 20% more likely to develop endometriosis.
The association remained after the researchers adjusted for isotretinoin use and tetracycline use. Infertility history or body mass index did not influence the results, and the link was independent of skin and hair characteristics.
The authors concluded that the most likely mechanism may be genetics.
You can read the full study in the Oxford Journal of Human Reproduction online.