Should You Worry About Heart Health With Endometriosis?

If you have endometriosis, chances are you’re focused on managing symptoms that involve your pelvis. Pain, heavy periods, fatigue, and fertility are often top-of-mind if you live with endo, but you may not know that your heart and blood vessels are also at risk. In fact, there’s mounting evidence that endometriosis raises your risk for cardiovascular disease.

It’s not meant to be another thing to worry about, but to offer insight and some simple steps you can take. Research is just beginning to explore how endometriosis can affect the body beyond the pelvis. Knowing the connection—and the tools for advocacy—may be worth your long-term health and well-being.

Endometriosis Affects More Than Your Reproductive Organs

For a long time, endometriosis was considered a “gynecological issue,” or a women’s health or fertility disorder. But researchers are now beginning to understand it as a systemic inflammatory disease. Inflammation from endo can affect the lining of your blood vessels (arteries and veins) and more rarely, your internal organs outside the pelvis like the heart or lungs.

If you have endometriosis, it’s very likely you have ongoing systemic inflammation (a low level of stress throughout your body). Chronic inflammation, along with the pain and fatigue, can damage the lining of your blood vessels and affect your cardiovascular (heart and blood vessel) health by making them less flexible and more prone to plaque buildup (atherosclerosis), which is the root cause of most heart attacks and strokes.

In other words, endometriosis’s effects on the body go beyond the reproductive organs.

Factors That Link Endometriosis and Cardiovascular Disease

• Inflammation and oxidative stress: The biggest culprits. These factors can weaken the healthy lining of your arteries, making them “stiffer.” This can lead to higher blood pressure and risk for heart disease and vascular (blood vessel) conditions.
• Hormonal and metabolic shifts: Endometriosis is associated with changes in estrogen and other hormones. It’s also tied to higher levels of substances in your blood that can directly influence your heart.
• Vascular effects: Some evidence shows endometriosis can actually change the way your blood vessels function in a way that could contribute to higher blood pressure or premature hardening of the arteries.

These are complex issues that researchers are just beginning to connect. The bottom line? Women with endometriosis may be more susceptible to certain cardiovascular conditions (especially heart attack and stroke) than women without it.

The risk isn’t high for every woman with endometriosis, but it’s real enough that heart health checkups should be part of your health plan—not just pelvic ultrasounds or monitoring pain and periods.

Could Heart Medications Help Endometriosis?

Studies are just beginning to explore whether medications commonly prescribed for cardiovascular disease—such as statins (cholesterol-lowering drugs) and metformin (an anti-inflammatory diabetes medication)—might also offer benefits in reducing endometriosis symptoms due to the conditions’ shared molecular pathways.

Statins and metformin are not yet standard of care for endometriosis itself, and research is ongoing. But these drugs could have a “two-for-one” effect if you already have risk factors for diabetes or high cholesterol: helping your heart and endo symptoms by reducing inflammation.

It’s not too early to be aware and learn about these and other options, even if you don’t need these drugs right now. This knowledge can be useful if you have other risk factors like family history or high blood pressure or cholesterol. It’s also one more reason to find a healthcare team who communicates.

Endometriosis Mimicking Heart or Lung Conditions

Rare, but possible. Most people with endo only have symptoms in the pelvis, but cases are reported where it affects the blood vessels and rarely, other organs like the heart and lungs.

When endometriosis grows outside the pelvic area, it can cause symptoms like:

• Chest pain or pressure that comes and goes with your period
• Shortness of breath or a new cough that doesn’t have an obvious cause

Rare doesn’t mean not possible, especially for people with deep infiltrating endometriosis. It’s worth mentioning to your doctor or gynecologist if you have any of these symptoms that seem worse or coincide with your period. These symptoms may be misdiagnosed as anxiety or as an unrelated heart or lung issue, which can delay appropriate treatment.

How to Take Care of Your Heart (or Prevent Heart Disease)

Managing cardiovascular (heart and blood vessel) health doesn’t mean you need to overhaul your life or give up on managing your endo symptoms. It does mean being aware, monitoring, and being proactive.

Key steps:

• Get a “cardiovascular risk check: ” This just means regular blood pressure checks, cholesterol screening, and blood sugar levels are more important if you have endo. Ask your doctor how often you should be screened.
• Heart-healthy lifestyle: A Mediterranean-style diet, regular gentle exercise when possible, and not smoking if you do can help endo and heart disease.
• Monitor new or unusual symptoms: Chest pain, racing heartbeat, or shortness of breath should not be ignored (especially if they are tied to your menstrual cycle).

Questions to Ask Your Doctor About Cardiovascular Disease and Endometriosis

• Should I have my heart health monitored more closely because I have endometriosis?
• Are there lifestyle changes or medications that could help both my endo symptoms and my cardiovascular risk factors?
• How do other risk factors (like my family history or my cholesterol) affect my personal risk and plan?
• Is there a way to have a care plan that involves primary care, my gynecologist, and possibly a cardiologist as part of a “team” approach?

Warning Signs

Pelvic pain is one side of the endo conversation, but don’t ignore:

• Chest pain or unusual pressure, with or without a link to your menstrual cycle
• Shortness of breath, especially if it’s new or seems to get worse with your period
• Sudden pain that’s much more intense than your usual flares

Rare, yes, but red flags. Don’t be shy or afraid to insist on answers and solutions if you experience any of these.

Research Needs, or What We Still Don’t Know

There are many unanswered questions about the relationship between endometriosis and cardiovascular risk. If you have endometriosis, you may or may not also have heart and blood vessel issues. But we also don’t yet know enough to show that statins or metformin should be used by all women with endometriosis to help the heart and potentially reduce endo symptoms.

Age, genetics, your overall health, and level of inflammation all affect your personal risk. A tailored care plan that meets you where you are is much more important than a “one-size-fits-all” approach.

If you’re living with endometriosis, you deserve a health care team that takes a whole-person approach, not just a pelvic or period-focused one. Being informed and proactive about your heart health is one more empowering step to take care of your future, in addition to your daily endo symptoms.