Results from a systematic review and meta-analysis of 28 studies suggest women with one or more common gynecological disorders such as endometriosis or polycystic ovary syndrome are at increased risk for cardiovascular or cerebrovascular disease.
Cardiovascular or cerebrovascular disease, including conditions such as ischemic heart disease, peripheral vascular disease, heart failure, and atrial fibrillation, kills more people around the world than any other disease.
“In 2019, there were 10.3 million new cases of cardiovascular or cerebrovascular disease in patients assigned female at birth across member countries of the European Society of Cardiology compared with 9.6 million new cases of patients assigned male at birth with cardiovascular or cerebrovascular disease,” wrote lead author Giorgia Colombo, a clinician at the Department of Obstetrics and Gynecology at the Regional Hospital of Lugano in Switzerland, and colleagues in the journal Heart.
Despite these statistics, women or people assigned female at birth are less likely to receive appropriate medical care for cardiovascular or cerebrovascular disease due to outdated assumptions that men or people assigned male at birth are more likely to experience these conditions.
Non-malignant gynecological diseases including polycystic ovary syndrome (PCOS), endometriosis, adenomyosis, uterine fibroids, primary dysmenorrhea, chronic pelvic pain, menstrual cycle irregularity, heavy menstrual bleeding, and abnormal uterine bleeding have recently been suggested to increase cardiovascular disease risk, but the exact nature and extent of such an association are not clear.
In the current study, Colombo and colleagues carried out a meta-analysis of 28 studies, including observational studies, that had a combined cohort of 3,271,242 people. The studies all included risk estimates for cardiovascular or cerebrovascular disease linked to non-malignant gynecological disorders.
Overall, the risk for composite cardiovascular or cerebrovascular disease was increased in people with one or more gynecological conditions by 28% compared to those without these conditions. Similarly, the risk for ischemic heart disease and cerebrovascular disease was increased by 41% and 33%, respectively, in people with one or more gynecological conditions.
When specific gynecological conditions were considered, endometriosis or polycystic ovary syndrome was associated with the highest risk for cardiovascular disease.
The results of this study are suggestive, but more research is needed to confirm the degree of and type of associations discovered by the research team.
“The results of this systematic review and meta-analysis may have implications for clinical practice,” concluded the authors. “Although the extent of this association is still to be explored, and causality has not been established, the findings suggest that it is important to raise awareness of the potential association between non-malignant gynecological diseases and cardiovascular or cerebrovascular disease both in the general public and healthcare professionals.”
