Research has unveiled a concerning link between endometriosis and an elevated risk of stroke, particularly for those undergoing certain medical treatments. A recent study indicates that individuals who have undergone hysterectomy and/or oophorectomy face a 39% increased risk of stroke. Additionally, postmenopausal hormone therapy elevates stroke risk by 16%. In the United States, more than 11% of people with female anatomy are affected by endometriosis, a chronic inflammatory condition. The study observed 893 women experiencing strokes during the investigation period.
The Nurses' Health Study II provided a large dataset for this research, encompassing 112,056 women aged 25 to 42. Of these participants, 5,244 had clinically diagnosed endometriosis. Researchers collected data every two years over 28 years, analyzing potential confounders or risk factors for stroke. Notably, smoking emerged as a significant factor, increasing stroke risk by 63%. The study found no correlation between endometriosis and stroke concerning age, infertility history, BMI, or menopausal status.
Dr. Stacey Missmer emphasized that not everyone with endometriosis will have a stroke. She stated:
"There is no reason to panic that everyone who has endometriosis is going to get a stroke."
The research highlights an increased risk of cardiovascular disease and stroke in women undergoing hormone replacement therapy, particularly those on a combined estrogen-progesterone regimen. A 2022 study revealed that women with endometriosis had a 34% higher risk of experiencing a stroke compared to those without the condition. The majority of strokes among this group occurred in individuals who underwent surgical procedures or hormone therapy impacting hormone levels.
Dr. Farland explained:
"We hypothesize that it may be a combination of inflammation, increased risk of cardiovascular disease risk factors, such as hypertension and high cholesterol, and possibly earlier age at menopause, induced by gynecologic surgery."
The study underscores the importance of awareness regarding the potential health risks associated with treatments for endometriosis. Dr. Missmer reiterated:
"There are circumstances when a hysterectomy and/or oophorectomy is the best choice for a woman, however, we also need to make sure that patients are aware of the potential health risks associated with these procedures."
The data suggests that hysterectomy and oophorectomy can significantly elevate stroke risk, especially in younger patients for whom the surgery induces premature menopause. Dr. Koythong noted:
"Hysterectomy when combined with bilateral oophorectomy can increase risk of stroke, particularly in younger patients for which the surgery would result in premature menopause."
Dr. Chaudhari added:
"There is an increased risk of cardiovascular disease and stroke in women placed on hormone replacement therapy, specifically a combined estrogen-progesterone combination."
Additionally, Dr. Chaudhari pointed out:
"However, there is data to suggest an increased risk of cardiovascular events such as heart disease and stroke are associated with oophorectomy that results in surgical menopause."
Despite these findings, it is crucial to balance treatment options for endometriosis while considering the overall health of the patient. Dr. Koythong emphasized:
"We have to balance treatment of the disease itself while also considering the patient as a whole, who is still at risk for other chronic diseases."
An important takeaway from the study is the heightened stroke risk during the first year of hormone replacement therapy. This information serves as a critical reminder for healthcare providers and patients alike to remain vigilant about stroke symptoms and other cardiovascular concerns.
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