Why the risk of heart disease increases in women with endometriosis. New study explains triggers [Beuzz]

Endometriosis is a chronic estrogen-dependent inflammatory disease in women of childbearing age, where endometrial tissue grows outside the uterus. It causes sharp pelvic pain and heavy menstrual bleeding, with the external problem behaving exactly like the uterus. But because this tissue has no way out of your body, it gets trapped. When endometriosis involves the ovaries, cysts form.

WHAT THE NEW STUDY SAYS

The results indicated that endometriosis significantly increased the risk of cerebrovascular disease and ischemic heart disease. A total of six studies were included in the meta-analysis comprising 254,929 participants. Three of these studies reported an increased risk of ischemic heart disease in women with endometriosis compared to women who did not have endometriosis. The researchers discussed various mechanisms that could explain the elevated risk of cardiovascular disease in patients with endometriosis. They attributed it to inflammation, endothelial dysfunction, increased oxidative stress, the relationship between inflammatory markers and microvascular dysfunction, and an atherogenic lipid profile associated with endometriosis. Two of the studies reported that endometriosis in premenopausal women was associated with increased arterial stiffness, which means a higher risk of cardiovascular events. Endometriosis has further been found to be linked to high cholesterol and hypertension. Oral contraceptives for women with endometriosis and early menopause in them were also linked to cardiovascular disease. Surgical menopause by hysterectomy has been found to increase the risk of cardiovascular events due to the abrupt drop in estrogen levels after surgery. Additionally, the use of analgesic medications to manage pelvic pain and the psychological and emotional stress associated with endometriosis worsens cardiovascular risk in women.

WHAT THE STUDY MEANS FOR WOMEN

“Endometriosis is a chronic, estrogen-dependent gynecological condition, which means women will always need to treat it as a risk factor for associated cardiac risks. This study only corroborates a growing number of studies that show that endometriosis is linked to a high risk of myocardial infarction, angina and atherosclerosis. Women with endometriosis may have a longer-term heart risk than those without. In fact, women with endometriosis are three times more likely to have a heart attack, develop chest pain, and need surgery for a clogged artery,” says Dr. Suman Lal, Directoe and HOD , Obstetrics and Gynecology, Max Hospital, Gurgaon.

What are the triggers of heart disease in women with endometriosis? “It is usually chronic inflammation caused by endometriosis, oxidative stress and abnormal lipid profile. These three elements play a key role in increasing heart risk in women. Chronic inflammation accelerates the plaque formation.Oxidative stress increases vascular inflammation while abnormal lipids increase atherogenesis or the process of plaque formation in the layers of the arteries.Thus all of these result in increased thickness of the coronary vessels and cause a myocardial infarction,” adds Dr. Lal. She also explains that women with endometriosis should opt for surgical menopause, which involves hysterectomy and removal of the ovaries early in life. “We have since women with surgical menopause are at a higher risk of developing coronary heart disease compared to women who go through natural menopause,” she says.

The only advice for women with endometriosis, suggests Dr. Lal, is to be especially mindful of routine cardiac profile tests to ensure there are no complications, to quit smoking, to have a healthy and balanced diet, to control blood pressure and obesity and to prevent the onset of diabetes.