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Dr Odile Bagot (Gynecologist-obstetrician)
Medical validation:
July 28, 2022
Women with endometriosis have a higher risk of stroke. Even if the absolute risk remains low, it could lead these patients to monitor their cardiovascular health more carefully.
This large study, published on July 21, 2022 in the American journal stroke suggests that women with a history of endometriosis, a chronic gynecological condition characterized by the development of a uterine lining outside the uterus, may be at higher risk for stroke.
Nearly 112,056 women were observed
To reach this conclusion, the researchers analyzed data from 112,056 nurses, aged 25 to 42, for nearly 28 years (between 1989 and 2017). In this group, 5244 women had endometriosis.
Their risk factors (alcohol consumption, physical activity, diet, body mass index, menstrual cycle, exposure to oral contraceptives and postmenopausal hormones, history of smoking, etc.) were taken into account. The objective: to understand the link between endometriosis and stroke (ischemic or hemorrhagic).
Surgical removal of the uterus would increase the risks
According to the results of the survey, women with endometriosis had a higher risk of stroke (+34%) than those without (106,812). Furthermore, the majority ofrisk of stroke associated with endometriosis” was related to hysterectomy (surgical removal of the uterus) and/or oophorectomy (39%) and postmenopausal hormone therapy (16%).
“IThere are circumstances where a hysterectomy and/or oophorectomy is the best choice for a woman, however, we must also ensure that patients are aware of the potential risks associated with these procedures“, wishes to clarify Stacey A. Missmer, lead author of the study and professor of obstetrics, gynecology and reproductive biology at Michigan State University College of Human Medicine.
These results, although interesting, must therefore be taken with a bit of perspective. This does not prevent women affected by the disease “to be attentive to the potential first cardiac signs”but also to discuss preventive options with their doctor.
For Dr. Odile Bagot, these findings can be partly explained:
“People who have a significant inflammatory terrain, such as women with endometriosis, have a higher risk of stroke. Regarding the removal of the ovaries, if the risk of stroke seems to increase, it is surely due to the naturally protective effect of estrogens. Finally, the high risk of stroke linked to removal of the uterus can be explained by reason of severe endometriosis, and therefore of a higher inflammatory terrain”says the gynecologist.
The symptoms of the disease, chronic or periodic, are many and varied.
These are the following signs:
- Pain ;
- Menstruation pain (dysmenorrhea);
- Pain during intercourse (dyspareunia);
- Frequent pelvic pain;
- Painful defecation;
- Difficulty urinating (dysuria);
- Pelvic pain that may radiate into the leg (cruralgia).
Sometimes endometriosis is asymptomatic, which greatly delays the diagnosis.