If you have or had severe acne as a teenager, you might find it more difficult to have a baby later in life, at least according to some recent research that has linked severe or ongoing acne and endometriosis.
This latest study confirms what many have known for a while in the dermatology community: acne can be an indicator of underlying hormonal disturbance that affects more than just the skin.
What is Endometriosis?
Endometriosis affects around 10% of women and is often not diagnosed until several years after symptoms first began. The condition is so named because it involves endometrial tissue (the type of tissue that lines the uterus) growing where it shouldn’t. Endometrial tissue is responsible for the production of the blood-lining that is shed each month during a menstrual period.
In people with endometriosis, there may be endometrial tissue trapped in the pelvic area or abdomen (or, rarely, elsewhere), and this can cause pain and other symptoms. This tissue may still produce blood, just as the lining of the womb develops and sheds each month.
There is currently no clear cause of endometriosis, but there are some who believe that the condition develops when period blood travels back up the fallopian tubes and travel outside of the uterus. There are likely to be many causes of endometriosis, including hormonal, genetic, and immunological factors.
Symptoms of Endometriosis
Symptoms of endometriosis typically include abdominal pain and pelvic pain, as well as bleeding between periods, pain when having sex, bleeding in between periods, irregular periods, and also reduced fertility. The latter symptom can be a result of adhesions caused by the endometrial tissue that lead to fallopian tubes becoming blocked.
Following this latest research, acne may also be counted as a symptom of endometriosis, with those women who have a history of severe acne in their teenage year at a much higher risk of developing the reproductive condition.
Dr. Jing Xie of Harvard Medical School in Boston, lead author of the study, said that severe teen acne could offer an early warning sign for endometriosis, a condition typically missed early on as symptoms are not easily observed. This means that by the time a diagnosis is made, it may be that adhesions have grown and caused tissue damage that makes conception or pregnancy less likely to succeed.
What’s the Connection between Acne and Endometriosis?
Although there is no confirmed cause of endometriosis, there is evidence that people with altered expression of a gene (c-myc) located on chromosome 8q24 have a higher risk of developing the condition. A single nucleotide polymorphism, i.e. an abnormality in a specific gene, also on chromosome 8q24 has been associated with a four-fold increase in the risk of severe teenage acne, providing a possible early indicator of abnormalities on this chromosome and of a higher risk of endometriosis.
Indeed, the latest research by Dr. Xie and colleagues found that women who reported having suffered from severe acne as teenagers had a 20% increased risk of developing endometriosis. The researchers used data from 88,623 women followed from September 1989 to June 2009 as part of the Nurses Health Study II, and during follow-up screening they found 4,382 new confirmed cases of endometriosis.
In case there was any chance that acne medication, such as isotretinoin and tetracycline antibiotics, was responsible for this apparent increase in the risk of endometriosis, the researchers controlled for this variable and found that the 20% higher risk remained. The researchers also controlled for infertility history, body mass index, and skin and hair characteristics of the participants, with these factors having no effect on the risk.
This left Dr. Xie and colleagues to conclude that the link between acne and endometriosis is genetic, with the likely involvement of sex hormones and/or immune system problems.
What Can You Do?
What this means for anyone with severe teenage acne, or a history of severe teenage acne, is that they may want to pay close attention to any symptoms suggestive of endometriosis, and take steps to reduce their risk of hormonal imbalance and immunological problems. Getting an early diagnosis can also mean that symptoms may be more easily managed, and that areas of problematic tissue could be removed before permanent damage is done that could affect chances of conception.
This latest research shows that, as is often the case, skin conditions are often an outward sign of deeper health issues. Find out more about the links between acne and hormone health, and how to tackle both in my latest book, Eat to Beat Acne: how a plant-based diet can help heal your skin.
Xie J, Kvaskoff M, Li Y, Zhang M, Qureshi AA, Missmer SA, Han J. Severe teenage acne and risk of endometriosis. Hum Reprod. 2014 Nov;29(11):2592-9. doi: 10.1093/humrep/deu207. Epub 2014 Aug 19. Available at: http://humrep.oxfordjournals.org/content/29/11/2592