Studies Show that Endometriosis May Increase Stroke Risk.
One in 10 women has endometriosis . This is when endometrial tissue, which looks like endometrium, grows on the outside of their uterus and affects other organs.
Endometriosis occurs when women reach childbearing years. Although it can often cause pain and fertility issues, the condition has been long treated as a health issue. But a new study highlights the importance of understanding how endometriosis may affect other parts of the body.
According to a study published in Stroke on July 21, women with endometriosis may be at a higher risk of having a stroke.
"The takeaway message is that, though important, endometriosis isn't just about symptoms such as fertility issues or debilitating pelvic pain - but also about a whole-body focus on women's well-being," says Stacey A. Missmer, doctor of science in epidemiology and a professor of obstetrics, gynecology, and reproductive biology at Michigan State University, who co-authored the study.
Dr. Missmer suggests that people with endometriosis should think about their overall health and their heart health.
The study authors used data from the Nurses' Health Study II, which included female nurses who were followed for 28 years, from 1989 to 2017. All of the participants started the study when they were between ages 25 and 42, and the majority were white. Researchers recorded a variety of conditions over the course of almost three decades.
For the study, researchers included more than 5,200 women from the Nurses' Health Study II who had endometriosis and nearly 107,000 who did not have the condition. Researchers found that endometriosis patients were 34% more likely than non-endometrists to suffer a stroke. The stroke risk for women with endometriosis was 40 percent greater than that of women who have had a hysterectomy or an oophorectomy. Researchers also discovered no differences in stroke risk among patients who had undergone a hysterectomy (when the uterus is removed) or an oophorectomy (when one or both of their ovarian cysts are removed).
Olga Bougie is an assistant professor at Queens University Kingston in Ontario. She specializes in minimally-invasive gynecologic surgeries. It's vital to realize that there are still very low risks of suffering from stroke.
Although it sounds scary, this does not necessarily mean people who have endometriosis are at a 34% chance of suffering a stroke. The number is much much smaller," says Dr. Bougie, who was not involved in the study.
The Centers for Disease Control and Prevention estimates that about one in five women aged 55-75 will suffer from strokes, regardless of their endometriosis. (The CDC has not collected data yet on women born to a female gender and who do not live as women. The CDC estimates that only 1 percent of strokes occurs in those aged between 15 and 49. However, this number is on the rise over the last decade.
Since long, stroke risk factors have been recognized by healthcare providers, including high blood pressure, obesity and smoking. Researchers are now beginning to understand how endometrium and cardiovascular disease can be linked.
A small Polish study published in Kardiologia Polska (Polish Heart Journal) in 2020, included 44 women with endometriosis and 76 women of the same age who did not have the condition. Endometriosis is associated with thicker arterial walls. This makes it harder for the heart to pump blood, and can lead to heart disease.
A much larger British study published in BJOG: An International Journal of Obstetrics and Gynaecology in 2021 included more than 50,000 women with endometriosis and nearly 224,000 without the condition. Research showed that women with endometriosis were 25 percent more likely than those without the condition to develop cardiovascular disease. Just under 20% of them were more likely to suffer from cerebrovascular disease (which includes stroke).
Bougie said that the growing research is new and everyone needs to know about the signs and symptoms associated with stroke.
"It's too early for us to suggest people with endometriosis get extra screening - we need to look at populations other than the Nurses' Health Study to see if we are seeing this in other populations as well," says Bougie, noting that future studies will need to look at more racially diverse populations from different socioeconomic backgrounds.
She also believes there is a link between stroke and hysterectomy. However, it is still unclear why.
Missmer states that patients with endometriosis may require the involvement of specialists such as cardiologists in their care.
She says, "They must focus on their full body health."