Recent studies have found that people with endometriosis have a higher risk of developing lupus, a type of autoimmune disease. Endometriosis is a chronic gynecological illness that affects approximately 10 percent of all women of reproductive (child-bearing) age. The condition occurs when endometrial tissue that normally lines the inside of the uterus grows in locations outside of the uterus, including the fallopian tubes, ovaries, and other organs in the pelvis and abdomen. The abnormal tissue growth leads to pain and other endometriosis symptoms.
Endometriosis has many common comorbidities (co-occurring conditions), including lupus. If you have endometriosis, here’s what to know about lupus, its connection to endometriosis, and the impact of having both conditions.
Lupus is an autoimmune disease that typically affects the entire body. In an autoimmune disease, the body has an inflammatory immune response against itself. The body creates antibodies (autoantibodies) that mistakenly attack healthy parts of the body.
There are several types of lupus; the most common is systemic lupus erythematosus. The exact cause of lupus is not fully understood, but lupus is associated with inherited and environmental risk factors, including hormones and infection with certain viruses.
Signs and symptoms commonly seen with lupus include:
Lupus can also cause many severe complications if it’s not properly managed, including kidney failure, heart disease, and dangerous blood clots. Treatment options for lupus include:
Researchers are still unsure of the exact mechanisms that increase the risk of lupus with endometriosis. However, there are some similarities that may contribute.
For instance, autoantibodies against endometrial tissue are sometimes found in people with endometriosis. The immune system fails to recognize proteins in endometrial cells as part of the body and treats them as if they are foreign material.
What’s more, a specific variation of a gene called PTPN22 that’s linked to several autoimmune diseases — vitiligo, type 1 diabetes, rheumatoid arthritis, and lupus, to name a few — has also been linked to endometriosis. There is no evidence of cause and effect between autoimmune disease and endometriosis, but these conditions may have a shared underlying cause.
Both endometriosis and lupus are affected by estrogen. Lupus flares and worsening endometriosis symptoms often coincide with elevated estrogen levels during the menstrual cycle. In addition, 90 percent of people with lupus are women, suggesting a hormonal connection.
Another connection between endometriosis and lupus is that they both respond to antimalarial drugs such as hydroxychloroquine. Antimalarials currently used to treat lupus also show promise in treating endometriosis, according to animal research. Furthermore, antimalarials may actually reduce the risk of endometriosis in people with lupus.
Having lupus can complicate endometriosis in several ways. Lupus can cause pain in addition to the pain of endometriosis, which can make pain management more difficult. Both lupus and endometriosis are exacerbated by high estrogen levels, meaning that lupus flares and increased endometriosis symptoms may often occur together. Lupus also puts you at an increased risk of infection and slow healing due to immune dysfunction, which can make surgery for endometriosis more risky with a longer recovery time.
One very significant effect that lupus can have on endometriosis is limiting your choice of birth control methods. Certain types of hormonal contraception can worsen symptoms or are unsafe in certain people with lupus. The most effective forms of birth control that are safe for people with lupus are tubal ligation, intrauterine devices, and birth control implants.
On the positive side, treating lupus with antimalarial drugs can also help treat or prevent endometriosis. Treatments for lupus and endometriosis do not have much overlap, but care must be taken to check for interactions between medications when treating multiple medical conditions.
Lupus and endometriosis are chronic diseases that can be difficult to diagnose and are often overlooked by health care providers. Endometriosis, lupus, and other autoimmune diseases often occur together — if you have one, make sure your doctor looks for others before settling on a single diagnosis. Early detection can prevent complications from lupus and improve quality of life. Together, you and your health care team can create the right management plan to keep pain, fatigue, and other symptoms of either condition under better control.
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