Amy Shafrir




Assistant Professor
Research Interests
  • Epidemiology
  • Reproductive Health
  • Biological markers
  • Health Disparities
  • Qualitative Research
Research Summary

My current research interests include characteristics and biological markers that are related to receiving a diagnosis of endometriosis and to how well patients respond to endometriosis treatments over time. I conduct research mainly within the Women’s Health Study: from Adolescence to Adulthood, which has been following participants with and without endometriosis for over 10 years. I currently have a National Institutes of Health R21 grant to look at nerve growth factors in the fluid within the pelvic cavity and how levels of these nerve growth factors are related to chronic pelvic pain among participants with endometriosis. My goal is to identify a biological marker that can be used to determine which endometriosis patients will continue to have severe pelvic pain even after they have received endometriosis-related treatment. Recently, I have also started to conduct research in health disparities and endometriosis. I’m currently conducting a qualitative, interview-based study to assess how racial and ethnic groups may experience different barriers to reaching an endometriosis diagnosis, which on average takes seven years from the start of symptoms to receiving a diagnosis.

  • Sc.D., Epidemiology, Harvard T.H. Chan School of Public Health 
  • M.Sc., Public Health Research, University of Edinburgh, Scotland 
  • B.Sc., Biology, Stonehill College

Areas of Expertise
  • Chronic disease epidemiology
  • Biological markers of health and disease
  • Endometriosis and pelvic pain disorders
Recent Publications

Sieberg CB, Lunde CE, Shafrir AL, Meints SM, Madraswalla M, Huntley D, Olsen H, Wong C, DiVasta AD, Missmer SA, Sethna N. Quantitative somatosensory testing of the abdomen: establishing initial reference values across developmental age and biological sex. PAIN. 2023; [Accepted].

Cramer DW, Vitonis AF, Huang T, Shafrir AL, Eliassen AH, Barbieri RL, Hankinson SE. Estimated ovulatory years prior to menopause and postmenopausal endogenous hormone levels. Cancer Epidemiol Biomarkers Prev. 2023; [Online ahead of print].

Shafrir AL, Fan M, Eliassen AH, Thombre Kulkarni M, Terry KL, Hankinson SE, Missmer SA. Endogenous steroid hormone concentrations and risk of endometriosis in the Nurses’ Health Study II. American Journal of Epidemiology 2023 Apr 6;192(4):573-586.

Rahmioglu N … Shafrir AL (83rd of 137 authors) … Missmer SA, Montgomery GW, Morris AP, Zondervan KT. The genetic basis of endometriosis and comorbidity with other pain and inflammatory conditions. Nature Genetics 2023 Mar;55(3):423-436.

Sasamoto N*, Shafrir AL*, Wallace BM, Vitonis AF, Fraer CJ, Gallagher JS, DePari M, Ghiasi M, Laufer MR, Sieberg CB, DiVasta AD, Schrepf A, As-Sanie S, Terry KL, Missmer SA. Trends in pelvic pain symptoms over two years of follow-up among adolescents and young adults with and without endometriosis. Pain 2023 Mar 1;164(3):613-624. *Co-first authors

Shafrir AL, Vitonis AF, Wallace B, DiVasta AD, Sadler Gallagher J, Sasamoto N, Laufer MR, Terry KL, Missmer SA. Cohort profile: The Endometriosis pain QUality after Surgical Treatment (EndoQUEST) Study. PLoS ONE 2022 Jun;17(6):e0269858.

Burchardt NA, Eliassen AH, Shafrir AL, Rosner B, Tamimi RM, Kaaks R, Tworoger SS, Fortner RT. Oral contraceptive use by formulation and breast cancer risk by subtype in the Nurses’ Health Study II: a prospective cohort study. Am J Obstet Gynecol 2022 Jun;226(6):821.e1-821.e26.

Thombre Kulkarni M, Shafrir A, Farland LV, Terry KL, Whitcomb BW, Eliassen AH, Bertone-Johnson ER, Missmer SA. Association between laparoscopically confirmed endometriosis and risk of early natural menopause. JAMA Netw Open 2022 Jan;5(1):e2144391.

Shafrir AL, Martel E, Missmer SA, Clauw DJ, Harte SE, As-Sanie S, Sieberg CB. Pelvic floor, abdominal and uterine tenderness in relation to pressure pain sensitivity among women with endometriosis and chronic pelvic pain. European Journal of Obstetrics, Gynecology & Reproductive Biology 2021 Sep;264:247-253.

Burchardt NA, Shafrir AL, Kaaks R, Tworoger SS, Fortner RT. Oral contraceptive use by formulation and endometrial cancer risk among women born in 1947-1964: The Nurses’ Health Study II, a prospective cohort study. European Journal of Epidemiology 2021 Aug;36(8):827-839.

Shafrir AL, Palmor MC, Fourquet J, DiVasta AD, Farland LV, Vitonis AF, Harris HR, Laufer MR, Cramer DW, Terry KL, Missmer SA. Co-occurrence of immune-mediated conditions and endometriosis among adolescents and adult women. American Journal of Reproductive Immunology 2021 Jul; 86(1):e13404.

Shafrir AL, Wise LA, Palmer JR, Shuaib ZO, Katuska LM, Vinayak P, Kvaskoff M, Terry KL, Missmer SA. Validity of self-reported endometriosis: a comparison across four cohorts. Human Reproduction 2021 Apr;36(5):1268-1278.

Shafrir AL. Chronic pelvic pain: importance of compatible clinical trial outcomes [Mini Commentary]. British Journal of Obstetrics and Gynaecology 2021 Mar;128(4):635-636.

Shafrir AL, Babic A, Gates Kuliszewski M, Rice MS, Townsend MK, Hecht JL, Tworoger SS. Estrogen receptor-β expression of ovarian tumors and its association with ovarian cancer risk factors. Cancer Epidemiology Biomarkers & Prevention 2020 Nov;29(11):2211-2219.

Shafrir AL, Missmer SA. Towards subtypes – deep endometriosis oestrogen receptor-α expression [News & Views]. Nature Reviews Endocrinology 2020 Oct;16:541-42.

Sasamoto N, DePari M, Vitonis AF, Laufer MR, Missmer SA, Shafrir AL,* Terry KL*. Evaluation of CA125 in relation to pain symptoms among adolescents and young adult women with and without surgically-confirmed endometriosis. PLoS One 2020 Aug;15(8):e0238043. *Co-senior authors

Huang T, Shafrir AL, Eliassen AH, Rexrode KM, Tworoger SS. Estimated number of lifetime ovulatory years and its determinants in relation to levels of circulating inflammatory biomarkers. American Journal of Epidemiology 2020 Jul;189(7):660-70. 

Huang T, Shafrir AL, Eliassen AH, Rexrode KM, Tworoger SS. Huang et al. Respond to “Ovulation and Systemic and Localized Inflammation Markers” and “Capturing Women’s Reproductive Life Spans” [Response to Invited Commentaries]. American Journal of Epidemiology 2020 Jul;189(7):677-678.

Shafrir AL*, Farland LV*, Shah DK, Harris HR, Kvaskoff M, Zondervan K, Missmer SA. Risk for and consequences of endometriosis: A critical epidemiologic review. Best Practices & Research Clinical Obstetrics & Gynaecology 2018 Aug;51:1-15. *Co-first authors

Tucker DW, Getchell CR, McCarthy ET, Ohman AW, Sasamoto N, Xu S, Ko JY, Gupta M, Shafrir A, Medina JE, Lee JJ, MacDonald LA, Malik A, Hasselblatt KT, Li W, Zhang H, Kaplan SJ, Murphy GF, Hirsch MS, Liu JF, Matulonis UA, Terry KL, Lian CG, Dinulescu DM. Epigenetic reprogramming strategies to reverse global loss of 5-hydroxymethylcytosine, a prognostic factor for poor survival in high-grade serous ovarian cancer. Clinical Cancer Research 2018 Mar;24(6):1389-1401.

Harris HR, Rice MS, Shafrir AL, Poole EM, Gupta M, Hecht JL, Terry KL, Tworoger SS. Lifestyle and reproductive factors and ovarian cancer risk by p53 and MAPK expression. Cancer Epidemiology, Biomarkers & Prevention 2018 Jan;27(1):96-102.

Shafrir AL, Schock H, Poole EM, Terry KL, Tamimi RM, Hankinson SE, Rosner BA, Tworoger SS. A prospective cohort study of oral contraceptive use and ovarian cancer among women in the United States born from 1947 to 1964. Cancer Causes Control 2017 May;28(5):371-383.

Shafrir AL, Rice MS, Gupta M, Terry KT, Rosner BA, Tamimi RM, Hecht JL, Tworoger SS. The association between reproductive and hormonal factors and ovarian cancer by estrogen-α and progesterone receptor status. Gynecologic Oncology 2016 Dec;143:628-635.

Shafrir AL, Babic A, Tamimi RM, Rosner BA, Tworoger SS, Terry KT. Reproductive and hormonal factors in relation to survival and platinum resistance among ovarian cancer cases. British Journal of Cancer 2016 Nov;115:1391-1399.

Kotsopoulos J*, Shafrir AL*, Rice M, Hankinson SE, Eliassen AH, Tworoger SS, Narod SA. The relationship between bilateral oophorectomy and plasma hormone levels in postmenopausal women. Horm Cancer 2015 Feb;6(1):54-63. *Co-first authors

Shafrir AL, Zhang X, Poole EM, Hankinson SE, Tworoger SS. The association of reproductive and lifestyle factors with a score of multiple endogenous hormones. Horm Cancer 2014 Oct;5(5):324-35.

Honors and Awards
  • Best Clinical Poster Abstract Prize at 14th World Congress on Endometriosis, 2021


  • Reproductive, Perinatal, & Pediatric Epidemiology Training Grant Pre-Doctoral Fellow, 2013-2015, National Institute for Child Health and Human Development


  • Cancer Epidemiology & Prevention Training Pre-Doctoral Fellow, 2011-2013, National Research Service Award