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HRQoL was assessed using the Endometriosis Health Profile-30, and ACEs were measured using a validated 21-item questionnaire. Ordinal logistic regression models were used for analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Women who experienced ACEs were more likely to be diagnosed with endometriosis than those who did not. Among women with endometriosis, a clear dose-response relationship was observed, with higher cumulative ACE scores and greater trauma severity associated with progressively poorer HRQoL across all domains. In the 1973\u201378 cohort, the strongest associations between cumulative ACEs and HRQoL were observed in the domains of social support, self-image, and emotional well-being, with adjusted odds ratios (95% CIs) of 1.41 (1.24, 1.58), 1.41 (1.24, 1.60), and 1.30 (1.15, 1.46), respectively. Women reporting very\/extremely traumatic experiences also had significantly worse outcomes across all domains, particularly for social support 4.42 (2.36, 8.28), emotional well-being 4.38 (2.36, 8.12), and self-image 3.29 (1.77, 6.11). Psychological abuse, physical abuse, and household mental illness were consistently associated with poorer HRQoL, particularly in the social support domain. Similar patterns were observed in the 1989\u201395 cohort, though with some domain-specific variations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Childhood adversity significantly impairs HRQoL in women with endometriosis, particularly psychological abuse, physical abuse, and household mental illness. These findings highlight the need for trauma-informed care in endometriosis management, with careful consideration of the limitations of routine ACE screening.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11136-025-04160-1","type":"journal-article","created":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T09:32:59Z","timestamp":1769938379000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of adverse childhood experiences on health-related quality of life in Australian women with endometriosis: a population-based cohort study"],"prefix":"10.1007","volume":"35","author":[{"given":"Dereje G.","family":"Gete","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenny","family":"Doust","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sally","family":"Mortlock","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Abbott","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9610-5904","authenticated-orcid":false,"given":"Gita D.","family":"Mishra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,1]]},"reference":[{"issue":"3","key":"4160_CR1","first-page":"882","volume":"18","author":"K Asmussen","year":"2020","unstructured":"Asmussen, K., Fischer, F., Drayton, E., & McBride, T. 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