Endometriosis history linked to a slightly higher chance of death before 70 - study

A history of endometriosis or uterine fibroids may increase a woman’s long-term risk of dying before the age of 70, according to a large new study.

Fibroids, non-cancerous growths in or around the uterus, are estimated to affect two in three women at some point in their life, according to the UK National Health Service (NHS).

Endometriosis affects around 10 per cent of women of reproductive age and occurs when tissue similar to the uterus lining grows outside it. Women with endometriosis often face long diagnosis delays.

The study analysed data from over 110,000 women aged 25 to 42 who participated in the Nurses’ Health Study II, an investigation into the risk factors for chronic diseases in women, over three decades from 1989 to 2019. 

Endometriosis was linked to a 31 per cent higher risk of early death

Women with endometriosis had an all-cause death rate of 2 per 1,000 person-years, compared to 1.4 for those without the condition, according to the findings published in the British Medical Journal. 

After adjusting for factors like age, weight, physical activity, and smoking, endometriosis was linked to a 31 per cent higher risk of premature death, driven mainly by gynaecological cancers.

Fibroids, though not associated with overall early mortality, were linked to an increased risk of death from gynaecological cancers.

“Our results suggest that women with a history of endometriosis and uterine fibroids might have an increased long-term risk of premature mortality extending beyond their reproductive lifespan,” the study’s authors said in their conclusion, inviting care providers to consider these links.

The study was observational which means that researchers can identify associations but cannot prove that one condition directly causes the outcome.

There is evidence to suggest that both endometriosis and fibroids have been linked to chronic diseases such as hypertension, heart disease, and certain cancers, the authors said, but their impact on premature mortality has remained unclear.

“This study presents itself as a robust and well-founded work, based on data from the Nurses' Health Study II cohort, renowned for its rigour and comprehensiveness,” Francisco Carmona, a gynaecologist specialising in endometriosis, said in a comment about the study.

The methodology used by researchers added credibility and quality to the analysis presented, he said.

“This analysis underlines the need to consider gynaecological diseases in a broader context of comprehensive women's health. It also reinforces the importance of early and personalised management, with both clinical and health policy implications,” he added.

The impact of evolving diagnoses and ovary removal surgery, however, should be addressed in future research, he said.