The message is that it is important for primary healthcare professionals to take these 2 pathologies into account in their assessment of women’s health. Although endometriosis and uterine fibroids are common disorders among women of childbearing age.
Endometriosis affects approximately 1 in 10 women worldwide. The condition, characterized by the development of endometrial (uterus) tissue outside the uterus, such as near the ovaries and fallopian tubes, can be extremely painful, exhausting and significantly interfere with quality of life and daily operation. Studies have also demonstrated consequences of the disease on fertility.
Uterine fibroids are the most common benign uterine tumors. 25% of patients with these fibroids develop disabling symptoms, including heavy uterine bleeding, pelvic pain and infertility, which warrants both preventive measures and treatment. Made up of smooth muscle cells and a large connective tissue matrix, fibroids vary in size from almost microscopic masses to large masses that can enlarge and distort the uterus. It is estimated that 77% of women will develop fibroids in their lifetime, most of them by the age of 50. Finally, uterine fibroids are the leading cause of hysterectomy.
Growing evidence shows that these 2 conditions are associated with an increased long-term risk of chronic diseases, such as high blood pressure, heart disease and certain cancers, but their effect on the risk of premature mortality remains poorly understood. .
The study analyzes data from 110,091 women participating in the Nurses’ Health Study II, aged 25 to 42 years at inclusion. From baseline and every 2 years, participants reported any diagnosis of endometriosis (confirmed by laparoscopy) and uterine fibroids (confirmed by ultrasound or hysterectomy). The researchers also took into account possible confounding factors including age, ethnicity, reproductive history, use of HRT and oral contraceptives, regular use of aspirin or anti-inflammatories. and other health problems. The analysis finds that:
- during the 30 years of follow-up, 4,356 premature deaths were recorded, including 1,459 from cancer, 304 from cardiovascular diseases and 90 from respiratory diseases;
- the rate of premature death from all causes in women with and without confirmed endometriosis is 2 and 1.4 per 1,000 person-years, respectively;
- after accounting for possible confounding factors, endometriosis was found to be associated with a 31% higher risk of premature death, mainly due to deaths from gynecological cancers;
- although uterine fibroids do not appear directly linked to premature deaths from all causes, they are definitely associated with a higher risk of death from gynecological cancers.
The study, observational and based on self-declarations, does not demonstrate the cause and effect relationship and undoubtedly does not exclude the possible influence of other factors not taken into account. However, note the authors, it is This is a large-scale study with regular monitoring over nearly three decades, which reduces possible bias…
In other words, Women with a history of endometriosis and uterine fibroids may have an increased long-term risk of premature mortality beyond their reproductive lifespan.
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