Date of Award

January 2026

Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)

Department

Medicine

First Advisor

Jeffrey M. Cohen

Abstract

There remains a gap in the knowledge about the relationship between inflammatory disorders and common gynecological disorders, despite significant quality of life concerns for both. We examined the association between hidradenitis suppurativa (HS) and endometriosis, and the association between atopic dermatitis (AD) and uterine leiomyomas, both with a cross-sectional study using electronic health record and survey data from the National Institutes of Health’s All of Us Research Program.

The All of Us Research Program has a large United States-based cohort and focuses on traditionally underrepresented populations in research. We compared cases and controls, all assigned female at birth, using Pearson’s χ2 test and one-way analysis of variance (ANOVA), and odds ratios were generated using logistic regression in univariable and multivariable analyses. Sensitivity analyses were also performed and the multivariate odds ratios were stratified by age groups.

7.2% of those with HS and 3.3% of those without HS had a diagnosis of endometriosis (P<0.001). The odds of those with HS having endometriosis was significantly higher than in patients without HS (adjusted odds ratio 1.67, 95% confidence interval 1.36-2.02, P<0.001). After stratification, we observed that those over 60 years old with HS had the highest odds (adjusted odds ratio 2.63, 95% confidence interval 1.58-4.12, P<0.001).

17.3% of those with AD and 8.8% of those without AD had a diagnosis of uterine leiomyoma (P<0.001). The odds of those with AD having uterine leiomyomas was significantly higher than in patients without AD (adjusted odds ratio 1.60, 95% confidence interval 1.48-1.75, P<0.001). After stratification, we observed that those over 60 years old with AD had the highest odds (adjusted odds ratio 1.78, 95% confidence interval 1.58-2.01, P<0.001), closely followed by those 45 to 60 years old (adjusted odds ratio 1.71, 95% confidence interval 1.49-1.96, P<0.001).

This study found that HS patients have an overall significantly increased odds of an endometriosis diagnosis and that AD patients have an overall significantly increased odds of a uterine leiomyoma diagnosis. Future research is warranted to gain a deeper understanding of these relationships and how their co-occurrence could impact patients’ quality of life and therapy.

Comments

This is an Open Access Thesis.

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