Women with endometriosis are more likely to develop a stroke, according to a new study reported in the journal Stroke.¹ Women who underwent hysterectomy and/or oophorectomy were particularly at risk.

A total of 112,056 women who were a part of the Nurses’ Health Study II were enrolled for the present study to analyse the association between endometriosis and the development of ischemic stroke. A confirmed diagnosis of endometriosis was made in 5244 women by laparoscopy. Over almost three decades of follow-up, 893 strokes were recorded.

Women who were diagnosed with endometriosis were at an overall 34% higher risk of stroke than women who did not have the condition.

Researchers also examined if factors such as hypertension, high cholesterol, hysterectomy and/or oophorectomy and postmenopausal hormone replacement therapy (HRT) influenced this association. The risk increased by 39% among women who underwent hysterectomy and/or oophorectomy and by 16% among women taking HRT. Other factors such as age, infertility history, body mass index or menopausal status were found to have no impact on this association.

This study points out the need to examine the health of a woman with endometriosis in toto. It has only shown an association between the two and does not conclusively state that women with endometriosis will suffer a stroke. Management should therefore not be limited to treatment of endometriosis alone. Risk factors for stroke such as high BP, high cholesterol should also be looked for to evaluate their stroke risk. Patients should be educated about this potential risk, particularly in association with procedures like hysterectomy and/or oophorectomy, which is often the line of management adopted in women with endometriosis.

Reference

1. Leslie V Farland, et al. Laparoscopically confirmed endometriosis and risk of incident stroke: a prospective cohort study. Stroke. 2022 Jul 21, https://doi.org/10.1161/STROKEAHA.122.039250.