Is there a link between heart disease and endometriosis?

This study links the treatment of hysterectomy/oophorectomy to the association between endometriosis and heart disease (Mu et al., 2016). Estrogen has a protective effect on the heart, so low estrogen states induced by surgical menopause or long term estrogen suppression should be considered when considering treatment (Iorga et al., 2017). 

• Mu, F., Rich-Edwards, J., Rimm, E. B., Spiegelman, D., & Missmer, S. A. (2016). Endometriosis and risk of coronary heart disease. Circulation: Cardiovascular Quality and Outcomes, 9(3), 257-264. Retrieved from http://circoutcomes.ahajournals.org/content/9/3/257 

“In this large, prospective cohort, laparoscopically confirmed endometriosis was associated with increased risk of CHD. The association was strongest among young women. Hysterectomy/oophorectomy was associated with higher risk of CHD and could partially explain the association between endometriosis and CHD.”

• Iorga, A., Cunningham, C. M., Moazeni, S., Ruffenach, G., Umar, S., & Eghbali, M. (2017). The protective role of estrogen and estrogen receptors in cardiovascular disease and the controversial use of estrogen therapy. Biology of sex differences, 8(1), 1-16.  Retrieved from https://bsd.biomedcentral.com/articles/10.1186/s13293-017-0152-8   

“The lower incidence of cardiovascular disease in women during reproductive age is attributed at least in part to estrogen (E2). E2 binds to the traditional E2 receptors (ERs), estrogen receptor alpha (ERα), and estrogen receptor beta (ERβ), as well as the more recently identified G-protein-coupled ER (GPR30), and can exert both genomic and non-genomic actions. This review summarizes the protective role of E2 and its receptors in the cardiovascular system and discusses its underlying mechanisms with an emphasis on oxidative stress, fibrosis, angiogenesis, and vascular function.”

See “Effects of Long Term Low Estrogen States”