Women with a history of endometriosis are at increased risk of developing serious cardiovascular disease (CVD) after menopause.

Inflammation and Endometriosis: 

Endometriosis is characterized by endometrial-like tissue outside the uterus, leading to chronic inflammation. This inflammatory state is thought to contribute to developing various systemic conditions, including CVD. Chronic inflammation can promote atherosclerosis (hardening and narrowing of the arteries) and increase the risk of cardiovascular events.

Hormonal Factors: 

Hormonal imbalances, such as elevated estrogen levels and reduced progesterone levels, are common in women with endometriosis. These imbalances can influence lipid metabolism, vascular function, and endothelial dysfunction, which are all key factors in the development of CVD.

Shared  Risk  Factors: 

Endometriosis shares several risk factors for CVD. Obesity, sedentary lifestyle, smoking, and unhealthy dietary habits are known risk factors for both conditions. Women with endometriosis are more likely to have these risk factors, which can further increase their susceptibility to CVD.

Insulin Resistance: 

Insulin resistance is commonly observed in women with endometriosis. It can lead to metabolic disturbances, such as dyslipidemia and impaired glucose tolerance, associated with an increased risk of CVD.

Genetic and Environmental Factors: 

Genetic predisposition plays a role in both endometriosis and CVD. Genetic variations may contribute to inflammation, hormonal dysregulation, and altered lipid metabolism, increasing the risk of both conditions. Environmental factors, such as environmental toxins or pollutants exposure, may also contribute to developing endometriosis and CVD.

Impact of Menopause: 

Menopause is a critical period for women’s health, and it can further exacerbate the risk of CVD in women with a history of endometriosis. During menopause, hormonal changes occur, including a decline in estrogen levels. Estrogen is known to have cardioprotective effects, and its reduction after menopause can accelerate the development of CVD. 

Study Findings: 

Several studies have examined the association between endometriosis and CVD. A large population-based study published in Circulation: Cardiovascular Quality and Outcomes in 2012 found that women diagnosed with endometriosis had a higher risk of developing ischemic heart disease, which includes conditions like heart attacks and angina. More recent studies have focused on the postmenopausal period, suggesting an increased risk of CVD in women with a history of endometriosis.

In conclusion, women who have experienced endometriosis during their reproductive life may be at a higher risk of developing cardiovascular disease, particularly after menopause. Chronic inflammation, hormonal imbalances, shared risk factors, insulin resistance, and genetic/environmental factors associated with endometriosis contribute to this increased risk. Healthcare providers should be aware of this association and consider monitoring women with endometriosis for cardiovascular risk factors to ensure early detection and appropriate management.

What can you do to reduce or prevent cardiovascular and metabolic risks that cause increased morbidity and mortality?

Lifestyle Changes

Diet:

Adapting a healthy Mediterranean diet that emphasizes reduced red meat consumption, consistent and frequent consumption of legumes, consumption of vegetables daily as part of every meal, consumption of fish up to twice weekly, consumption of various nuts, and daily consumption of fruits. Use extra virgin olive oil for cooking; use the minimum amount of olive oil during the cooking process and add most of the oil after the cooking process is over, or you may add the olive oil at the time of serving on your plate. Olive oil has terrific therapeutic and preventive effects, and studies have shown that we should consume at least two ounces of fresh olive oil daily. 

Exercise:

Exercise at regular intervals. At least three times a week, but ideally, you should exercise five days a week. Vigorous walking is the safest exercise for cardiovascular health, but all aerobic exercises are essential. Exercise reduces the risk of gene mutations and cancer and promotes healthy longevity.

Use of high-quality nutritional supplements:

Modern work and leisure lifestyles make spare time for healthy home cooking and disciplined exercise routines difficult. For modern couples, the use of nutritional supplements becomes an important part of the process of achieving healthy longevity. The supplement industry is known for a high rate of fraudulent low-quality products. Price should never be the criterion for what you will consume; your health is essential, and you should spend what is appropriate and only buy high-quality nutritional supplements. The important thing is to ensure that you obtain a custom protocol that is right for your underlying risks and not simply buy what is advertised. At Kofinas Perinatal, we use high-quality supplements in our personalized protocols that correct the underlying pathological conditions and improve health.