Atherosclerotic cardiovascular disease in women with endometriosis: a systematic review of risk factors and prospects for early surveillance

Abstract

Currently available evidence suggests that women with endometriosis are at higher lifetime risk of developing atherosclerotic cardiovascular disease (ASCVD) than women without endometriosis. However, robust evidence is still severely lacking and future studies are needed to more definitively evaluate a possible causal association between ASCVD risk and endometriosis.

Type of menopause, age of menopause and variations in the risk of incident cardiovascular disease: pooled analysis of individual data from 10 international studies

“…Thus, the presence of uterine fibroids might not explain the difference with risk of CVD between surgical menopause and natural menopause. Evidence has shown endometriosis was associated with increased risk of CHD (Mu et al, 2016;Tan et al, 2019). The strong association observed between surgical menopause and incident CVD might be confounded by endometriosis.…”

Time-to-pregnancy and risk of cardiovascular disease among men and women

“…Other sex-specific factors that might be associated with differences in CVD risk according to subfertility include sex-hormone levels, underlying disorders related to fertility potential, use of assisted reproductive technologies and pregnancy complications [11][12][13][14][15]. Specific disorders that contribute to subfertility and an increased risk of CVD include polycystic ovarian syndrome (PCOS) [16,17] and endometriosis [18] in women, and varicoceles in men [19][20][21]. The large proportion of unexplained subfertility (20-30%) [1,2], and the underdiagnosis of conditions contributing to fertility problems [22][23][24], highlight the value of looking further at the relationship between TTP and risk of CVD.…”

Association between endometriosis and increased arterial stiffness

“…However, atherosclerotic CVD is a complex disease that begins at an early age and develops over decades. Endometriosis is also diagnosed at a young age, which may provide a window-of-opportunity for detection of subclinical atherosclerosis for these women and better risk stratification [10]. Non-invasive measurements of subclinical atherosclerosis evaluating different aspects of the atherosclerotic processes are widely used [19].…”

“…However, endometriosis is typically diagnosed at a relatively young age. This allows for risk estimation and diagnosis of CVD, while it is still within the subclinical stage [10].…”