Endometriosis is a chronic estrogen-dependent disorder traditionally regarded as a localized gynacological condition but increasingly recognized as a systemic disease with broader health consequences. Growing evidence indicates a link between endometriosis and cardiovascular disease, one of the leading causes of morbidity and mortality among women. This review examines the biological mechanisms, epidemiological evidence and clinical implications underlying this relationship. Several pathophysiological processes, including chronic inflammation, oxidative stress, immune dysregulation and hormonal imbalance, may contribute to endothelial dysfunction and vascular injury in women with endometriosis. Findings from observational studies and meta-analyses suggest an increased incidence of cardiovascular outcomes, particularly coronary artery disease and major adverse cardiovascular events. However, the causal nature of this relationship remains uncertain due to the predominance of observational evidence and the potential influence of confounding factors. Cardio metabolic comorbidities and treatment-related factors may further modify cardiovascular risk, highlighting the multifactorial nature of this association. Current evidence supports the need for greater attention to cardiovascular risk assessment, preventive strategies and multidisciplinary management in women with endometriosis. Further longitudinal research is required to clarify causal pathways, identify predictive biomarkers and evaluate the long-term impact of therapeutic interventions on cardiovascular outcomes.
Kausar et al. (Mon,) studied this question.
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