woman lying down with pelvic pain

Endometriosis and Heart Disease Risk

Private: Stacey Missmer, ScD
Contributor Stacey Missmer, ScD

Women with endometriosis, especially those 40 years of age or younger, may have a higher risk of heart disease, according to a recent study by researchers at Brigham and Women’s Hospital. The study examines the link between coronary heart disease – which occurs when plaque builds up inside the coronary arteries and causes damage in the heart’s major blood vessels – and endometriosis, a disorder in which tissue that normally lines the uterus grows outside of the uterus. Researchers reviewed the records of 116,430 women enrolled in the Nurses’ Health Study II. Endometriosis was diagnosed using surgical examinations in 11,903 women.

What did researchers learn about endometriosis and heart disease?

Women age 40 or younger with endometriosis were three times more likely to develop heart attack, chest pain, or need treatment for blocked arteries, compared to women without endometriosis in the same age group. Researchers noted that surgical treatment of endometriosis – removal of the uterus or ovaries – may partly account for the increased risk of heart disease. Surgically induced menopause prior to natural menopause may increase the risk of heart disease, and this elevated risk may be more evident at younger ages.

During 20 years of follow-up with participants, researchers found that compared to women without endometriosis, women with the condition were:

  • 1.35 times more likely to need surgery or stenting to open blocked arteries.
  • 1.52 times more likely to have a heart attack.
  • 1.91 times more likely to develop angina (chest pain).

What are the lessons for women with endometriosis?

“It is important for all women with endometriosis to adopt heart-healthy lifestyle habits, be screened by their doctors for heart disease, and be familiar with symptoms, because heart disease remains the primary cause of death in women,” says senior study author Stacey Missmer, ScD, director of Epidemiologic Research in Reproductive Medicine at the Brigham and scientific director of the Boston Center for Endometriosis.

An estimated six to 10 percent of women of reproductive age have endometriosis, but exact numbers are unknown, since it cannot be diagnosed without surgery. Many girls and women do not realize that distressing menstrual cramps and pelvic pain can be due to endometriosis.

Read more about the study in Circulation: Cardiovascular Quality and Outcomes, an American Heart Association journal.

Private: Stacey Missmer, ScD
Stacey Missmer, ScD

Stacey Missmer, ScD, is Director of Epidemiologic Research in Reproductive Medicine at Brigham and Women's Hospital and Scientific Director of the Boston Center for Endometriosis. Dr. Missmer is also a Lecturer on Pediatrics at Harvard Medical School.

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