Women with endometriosis, the growth of endometrial tissue outside the uterus, may have a higher risk of heart disease, especially those who are 40 or younger.

In what may be the first investigation linking coronary heart disease and endometriosis, researchers analyzed the records of 116,430 women enrolled in the Nurses’ Health Study II. During surgical examinations, endometriosis was diagnosed in 11,903 women.

The team, led by Dr. Fan Mu, the study’s lead author, who was a research assistant at Brigham and Women’s Hospital and Harvard Medical School in Boston, Massachusetts, when the study was conducted, discovered that patients with endometriosis were 1.35 times more likely to need surgery or stenting, which helps in opening blocked arteries.
These women were also 1.52 times more likely to have a heart attack and 1.91 times more likely to develop chest pains.

For the women in the age group of 40 or younger with endometriosis, the researchers found they were three times more likely to develop heart attack, chest pain or need treatment for blocked arteries, than women their age who did not have endometriosis.

“Systematic chronic inflammation, heightened oxidative stress and atherogenic lipid profile associated with endometriosis and the synergistic effect of the three may underpin the biologic mechanism for the association between endometriosis and coronary heart disease led us to conduct this study,” Dr. Stacey A. Missmer, senior study author, Director of Epidemiologic Research in Reproductive Medicine at Brigham and Women’s Hospital, told HCB News.

“Additionally, endometriosis and CHD may share common genetic susceptibilities,” she added.

The removal of the uterus or ovaries may partially account for the increased risk of heart disease, according to the study, and surgically-induced menopause prior to natural menopause may also increase risk of heart disease, and this elevated risk is more evident at younger ages.

Since the disease cannot be diagnosed without surgery, the exact number of women with endometriosis is unknown, although it is estimated to be between 6 and 10 percent.

“It is important for women with endometriosis — even young women — 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,” said Dr. Missmer.

The study accounted for oral contraceptives and hormone replacement therapy but the researchers were unable to evaluate details of other hormonal treatments for endometriosis.

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