Are heart attacks more likely if you have endometriosis?

Woman with endometriosis is clutching her stomach in pain, and being comforted by the nurse

Some newspapers have claimed that women are three times more likely to have a heart attack if they have endometriosis, a common condition that affects the uterus. We look behind the headlines.  

The Mail Online stated: “Women suffering endometriosis are nearly twice as likely to suffer heart attacks, angina and heart failure, researchers found.

"And younger women with the disease – those under the age of 40 – are three times as likely to have the heart problems,” it warned.   

Similarly, the Sun’s headline read: “Women who suffer bad periods are three times more prone to heart risk.” This coverage could have been misleading as – while people with endometriosis may have bad periods – bad periods are not the same thing as endometriosis and don’t in themselves mean you are more likely to get heart problems.  

More research is needed in this area to confirm whether endometriosis sufferers can be considered to be at higher risk

Whilst the Sun article went on to say that the risk was “up to three times more likely to have a heart attack” and “the risks are highest in the under-40s” it did not make it clear that the three times higher statistic refers only to under-40s, who would normally be at a very low risk of having a heart attack.

What the researchers found was that women age 40 or younger with endometriosis were three times as likely to have a heart attack, chest pain or need treatment for blocked arteries, compared to women without endometriosis in the same age group.  

Around two million women in the UK are estimated to have the condition, where the tissue that normally makes up the lining of the uterus (the endometrium) is found outside the uterus, for example in the ovaries or bladder.

Where did this story come from?

The claims are based on research published in the journal Circulation: Cardiovascular Quality and Outcomes‎. The researchers – from Harvard Medical School – reviewed the records of more than 11,000 women with endometriosis, and found that women with the condition were at a higher risk of developing coronary heart disease.  

The research cannot prove that the condition itself causes a higher risk of heart disease

Specifically, women with the condition 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 1.91 times more likely to develop angina (chest pain).  

However, this association could partly be due to the treatment of endometriosis – which for some women is a hysterectomy (removal of the uterus) – rather than the condition itself, the researchers said.

The BHF View

Emily Reeve, Senior Cardiac Nurse at the British Heart Foundation, explained: “Before the menopause, we know that women generally have a lower risk of being affected by coronary heart disease than they do post-menopause. 

“Having endometriosis can increase the possibility of having a hysterectomy, which can lead to early menopause, so it is possible that this may have influenced the results,” she added.  

This was not adjusted for in the study, so it is a limitation of the research. It found a link between endometriosis and heart problems, but cannot prove that the condition itself causes a higher risk of heart disease. 

Miss Reeve added: “This interesting study indicates a link between endometriosis and an associated higher risk of coronary heart disease; however, more research is needed in this area to confirm whether endometriosis sufferers can be considered to be at higher risk.

She said that all women – regardless of whether they have endometriosis – should regularly have check-ups with their doctor to understand their risk of developing coronary heart disease and make any necessary lifestyle changes. 

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