According to Endomteriosis.org, around 1in 10 women during their reproductive years. This chronic condition occurs when endometrial-like tissue grow outside the uterus, and on other organs like the fallopian tubes, ovaries, outside walls of the uterus, and even the bowel. Endometriosis is associated with symptoms like painful periods, painful ovulation, chronic pelvic pain, heavy bleeding, pain during or after sexual intercourse, fatigue, and infertility. Moreover, it also impacts one’s mental, physical, and social well-being overall.
What’s worse is that while it was once considered just a reproductive health condition, a new study has found that endometriosis may affect other parts of the body as well.
A study was published on July 21 in Stroke journal that shared how women with endometriosis may possibly at a higher risk for stroke.
Doctor of science and epidemiology, Stacey A. Missmer, who is also a professor of obstetrics, gynecology, and reproductive biology from Michigan State University and co-author of the study shared, “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.”
Dr. Missmer also shared that women with endometriosis also need to consider their whole-body health, especially their cardiovascular health.
The study authors took data from the Nurses’ health Study II, particularly information from female nurses that were followed over a period of 28 years, between 1989 to 2017. All of the participants began the study when they were between the ages of 25 to 42, with the majority of the women were white. Over the three decade span, the researchers recorded information and incidents of a variety of conditions, including strokes.
For the study, the research group included over 5,200 women from the Nurses’ Health Study II that were diagnosed with endometriosis and almost 107,000 that did not have the condition. What they discovered is that those with endometriosis were around one-third – or 34 percent – more likely to have a stroke as compared to those that did not. Moreover, women that had a hysterectomy, which is when the uterus is removed, or an oophorectomy, which is when one or both of the ovaries are removed, saw a higher risk of stroke by around 40 percent as compared to those women that didn’t have endometriosis. The research group also saw that there were ‘no significant differences when the patients had other risk factors, such as being older, being overweight, or those going through menopause.
Meanwhile, assistant professor at Queens University in Kingston, Ontario, Olga Bougie, MD, MPH, who was not part of the study but specializes in minimally invasive gynecologic surgery explains that it’s also important to understand that the relative risk of stroke is quite low.
She explains, “That number can sound very scary, but that does not mean that people with endometriosis have a 34 percent chance of having a stroke. The number is much, much smaller.”
The Centers for Disease Control and Prevention (CDC) shares that ‘about 1 in 5 women between the ages of 55 and 75 will have a stroke, regardless of endometriosis status.’ Notably, the CDC has not yet gathered data on those assigned female at birth but are not living as women. Moreover, the CDC also says that around 1 in 7 strokes occur in individuals aged 15 to 49, although that number has continuously increased throughout the last decade.
Most healthcare experts understand and recognize that there are a number of stroke risk factors, such as high blood pressure, diabetes, obesity, and smoking. But these days, researchers are also beginning to better understand the links between endometriosis and cardiovascular disease too.
In a small Polish study that was published in 2020 in the Kardiologia Polska (Polish Heart Journal), it included 44 women with endometriosis and 76 women of the same age who weren’t diagnosed with endometriosis. What they saw was that those with endometriosis had thicker arterial walls that those without. This means that their hearts need to work harder to pump blood, which is a risk factor for heart disease.
Another much bigger study from Britain published in BJOG: An International Journal of Obstetrics and Gynaecology in 2021 included over 50,000 women diagnosed with endometriosis, and almost 224,000 without it. The research group discovered that when compared to the women without endometriosis, those that did have it were around 25 percent more likely to have cardiovascular disease. They were also a bit under 20 percent more likely to have cerebrovascular disease, which also includes stroke.
Although the developing research on endometriosis and stroke risk is relatively new, Prof. Bougie shares that everyone should be aware of the signs of symptoms of stroke regardless of whether they have endometriosis or they don’t.
Prof. Bougie also shares, “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.” She also says that future studies will also need to look at more racially diverse populations from a variety of socioeconomic backgrounds too.
In addition, there is also an association between stroke and hysterectomy, although Prof. Bougie explains that it’s still not exactly clear why that is.
As for Dr. Missmer, she says that the primary care physician for patients with endometriosis should probably involve the care of a cardiologist to their patient’s care as well.
She adds, “They need to focus on full body health.”
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