By Tamer Seckin, MD
A new study out today is linking endometriosis to a higher risk of heart disease, particularly among women aged 40 years and under. The data shows that women in this age bracket are three times more likely to develop heart attack, chest pain or blocked arteries when compared to those without endometriosis of the same age. “This should be of real concern to doctor’s treating patients with endometriosis,” said Dr. Tamer Seckin, one of a handful of gynecologic surgeons in the United States who performs deep excision of endometriosis and is the founder of the Endometriosis Foundation of America (EFA) with Padma Lakshmi.
The study, published today in the Circulation: Cardiovascular Quality and Outcomes, an American Heart Association Journal, looked at the heart risk for women with endometriosis over a 20-year period. The study followed 120,000 women, of which about nearly 12,000 had endometriosis, and found that compared to women without endometriosis women with endometriosis were 1.35 times more likely to need surgery or stenting to open blocked arteries, 1.52 times more likely to have a heart attack and nearly two times as likely to develop angina.
“Studies on endometriosis are greatly needed, and I am pleased to see this research supported by the National Institute of Health,” said Seckin. Dr. Stacey Missmer, director of epidemiologic research and reproductive medicine at Brigham’s Women’s Hospital, who co-authored the study, spoke last year at the EFA’s 6th annual medical conference held in New York City.
According to the study, researchers noted that surgical treatment of endometriosis including the removal of the uterus and ovaries possibly accounts for the higher risk of heart disease. Seckin says this has been suspected for some time and is not a surprise to him. The study also reported that surgically induced menopause before natural menopause may also be an added risk.
The peer-reviewed paper also says that there is a specific and meaningful correlation between endometriosis and coronary heart disease. Seckin believes this may be due to the confounding systemic inflammation and chronic stress and pain.
Dr. Seckin urges that removal of the uterus and/or ovaries is not the optimal treatment for women with endometriosis. That is why he opts for deep excision surgery. Excision allows the surgeon to safely and successfully remove the disease and the inflammatory tissues.
“Deep excision surgery is about removing the endometriosis tissue from the body and preserving both the reproductive organs, and any other organs affected by the disease, as endometriosis often grows outside the reproductive tract in places like the bowel and colon,” said Seckin. “Treatment should offer a woman the best chance to regain a pain-free life, lessen long-term side effects from alternative therapies used to treat symptoms, and provide an opportunity for her to have children.”
Alternative therapies can include the use of oral contraceptives, hormone replacement therapy and painkillers for treating patients with endometriosis. The study did account for oral contraceptive and hormone replacement exposure but could not evaluate details of other hormonal treatments or the use of painkillers.
While he is busy advocating that the reproductive organs not be removed during endometriosis treatment, Seckin also expresses concerns about the dangers of long-term usage of hormones and pain medications. “These therapies have their risks,” he added.“Whether-or-not heart disease is one of these dangers, or the disease itself is the cause has still to be determined, but this study tells us something is increasing the risk for heart disease in women with endometriosis.”
Seckin said that the study convinces him that removing the disease through minimally invasive surgery gives women the most relief from their symptoms and does not expose them to side-effects that could put their overall health at risk.
– Tamer Seckin, MD, is an endometriosis specialist and surgeon in private practice in New York at Lenox Hill Hospital. He is the founder of the Endometriosis Foundation of America (EFA) with Padma Lakshmi. The EFA mission is to increase disease recognition, provide advocacy, facilitate expert surgical training, and fund landmark endometriosis research. Dr. Seckin is the author of “The Doctor Will See You Now; Recognizing and Treating Endometriosis” published March 2016 by Turner Publishing.