子宮内膜症は、これまで考えられていたよりも女性の体内のより多くのシステムに影響を与える(Endometriosis affects more systems in women’s bodies than previously understood)

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2025-08-20 ペンシルベニア州立大学(PennState)

ペンシルベニア州立大学の研究は、子宮内膜症が婦人科領域だけでなく自律神経系にも影響を及ぼすことを明らかにした(Hypertension掲載)。患者は運動や冷水刺激といったストレス時の血圧上昇が健常者より低く、循環応答に異常がみられる。めまいや軽度の血圧変動など、従来見逃されがちな症状も内膜症に関連する可能性がある。また、病巣を外科的に除去しても血圧反応の変化は残存し、単なる手術だけでは不十分で包括的な管理が必要とされる。さらに血圧や循環応答を利用した非侵襲的検査は、早期診断法として有望と考えられる。本研究は子宮内膜症を全身性疾患として捉える必要性を示した。

<関連情報>

子宮内膜症を有する女性における血圧反射の異常 Altered Blood Pressure Reflexes in Women With Endometriosis

Auni C. Williams and Lacy M. Alexander
Hypertension  Published 1 August 2025
DOI:https://doi.org/10.1161/HYPERTENSIONAHA.125.25089

Graphical Abstract

子宮内膜症は、これまで考えられていたよりも女性の体内のより多くのシステムに影響を与える(Endometriosis affects more systems in women’s bodies than previously understood)

Abstract

BACKGROUND:

Endometriosis is a risk factor for cardiovascular disease. COX (Cyclooxygenase) is upregulated in endometriotic lesions, potentially exaggerating pressor reflexes, a major risk factor for adverse cardiovascular events. The purpose of this study was to determine whether women with endometriosis demonstrate exaggerated pressor responses. We hypothesized that women with endometriosis would show exaggerated blood pressure (BP) compared with healthy women during handgrip exercise and cold pressor testing (CPT).

METHODS:

In a single-blind, randomized, crossover design, women with (Endo; n=11) and without (healthy control [HC]; n=9) endometriosis underwent a CPT and handgrip with postexercise ischemia (HG+PEI) following aspirin (a nonselective COX inhibitor; 650 mg) or placebo. BP was continuously monitored during baseline (5 minutes) and hand submersion (3 minutes; 4–8 °C) during CPT, and during baseline (5 minutes), 30% maximal voluntary contraction handgrip (2 minutes), and postexercise ischemia (3 minutes) for HG+PEI.

RESULTS:

Women with endometriosis demonstrated attenuated pressor responses to CPT (change in mean arterial pressure [∆MAP] Endo 21±16 versus HC 34±20 mm Hg; P<0.01) and HG+PEI (HG+PEI: ΔMAP Endo=12±13/13±10 mm Hg, HC=24±14/20±8 mm Hg; P<0.01). There was no effect of aspirin on blood pressure response to either CPT or HG+PEI.

CONCLUSIONS:

Compared with age-matched HC, women with endometriosis demonstrate lower increases in blood pressure in response to cold exposure and exercise. Aspirin, a COX inhibitor, had no impact on these responses. Collectively, these results suggest that women with endometriosis demonstrate altered central integration and attenuated sympathetic outflow or end-organ responsiveness.

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