A whole-body condition?
The decreased blood pressure response among women with endometriosis suggests a reduced neurological response to the stress and may be the cause of lightheadedness, which has been previously reported as a symptom of endometriosis, the researchers explained.
“Compared to the crippling pain that endometriosis can cause, the lightheadedness associated with a decreased blood-pressure response is trivial,” said Williams, who conducted this research as part of her doctoral studies at Penn State. “What matters here is the evidence that the autonomic nervous system functions differently in women with endometriosis. Most of the women with endometriosis in our study had undergone surgery to remove lesions. While the gynecological issues had been addressed, the changes to their nervous systems were still present, so they demonstrated lower blood pressure increases than women without endometriosis.”
The findings are an example of how endometriosis can lead to symptoms outside of the reproductive system. In addition to lightheadedness, Lacy Alexander, professor of kinesiology at Penn State and coauthor of this study, and others have previously demonstrated that the cardiovascular system function is impaired by endometriosis. The combination of these findings demonstrates that endometriosis needs to be treated systemically, the researchers said.
“Any time women experience a symptom of any kind, they should tell their endometriosis-care provider. A side effect like lightheadedness may not seem related to a gynecological condition, but this study demonstrated that it very well could be,” said Alexander, who was Williams’s doctoral adviser and is currently her postdoctoral mentor.
To address low blood pressure, women with endometriosis should drink more water and potentially increase their salt intake, in consultation with their doctor, the researchers said. Doing so may help prevent lightheadedness, especially during exertion.
A less invasive way to diagnose endometriosis
It can take over six and a half years — and visits to three different medical specialists — for a woman to receive a diagnosis for endometriosis, according to the researchers. Currently, ultrasounds and MRIs can help doctors identify endometriosis lesions, but the only approved way to diagnose the condition is with surgery.
“These results may point to less invasive methods for diagnosing endometriosis,” Alexander said. “If — as this study shows — women with endometriosis have predictably lower blood-pressure increases in response to mild stressors, then there may be less invasive tests that would allow women to be diagnosed sooner. Tests like these could be conducted during a routine office visit and potentially prevent years of unnecessary suffering.”
The value of federal research support
Alexander said this project underscored the importance of federal research support. The project began when Williams came to Alexander’s office, expressing an interest in the potential effects of endometriosis on blood pressure responses. Together, they decided that Williams would apply for a research-training grant from the National Institutes of Health.
“This funding was intended to train Auni to conduct research at the intersection of gynecology and cardiovascular disease,” Alexander said. “It did that, but it also provided insights that might someday improve the lives of the millions of women who live with endometriosis in the United States. None of that would have been possible without federal funding.”
The National Heart, Lung and Blood Institute funded this research.
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