Endometriosis causally associated with ischemic stroke

Endometriosis has a causal link to ischemic stroke, according to a research letter published in the February issue of Stroke, a theme issue focused on the topic of cerebrovascular diseases and women, in conjunction with the American Heart Association Go Red for Women initiative.

Ming Zheng, M.D., Ph.D., from the Academy of Military Medical Sciences in Beijing and Shaoping Zheng, from the Beijing Institute of Basic Medical Sciences, examined genetically determined endometriosis in a stroke cohort with 521,612 participants. Genetic instruments of single nucleotide polymorphisms for endometriosis were selected from an endometriosis cohort of 77,257 participants. A total of 46 single nucleotide polymorphisms were selected with an average F statistic of 38.7. The risk for stroke was examined following endometriosis using Mendelian randomization (MR) analysis.

The researchers found that endometriosis was significantly associated with increased risks for ischemic stroke, including total and cardioembolic ischemic stroke. Risks for ischemic stroke were significantly increased for endometriosis subtypes of the ovary, pelvic peritoneum, rectovaginal septum, and vagina and occurring infertility. Causality was most significant for infertility-related endometriosis and cardioembolic ischemic stroke. This causal effect was significant across different MR tests.

"We strongly suggest a shift in the perception of endometriosis from a purely gynecological disease to a complex systemic disease involving increased stroke risk," the authors write.

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