Abstract：
Large-scale studies show endometriosis linked to earlier menopause onset. Recent research targeting women with laparoscopically diagnosed endometriosis found an increase in cases of early natural menopause. Furthermore, recent large-scale cohort studies have found a correlation between endometriosis and an increased risk of cardiovascular disease (CVD). Understanding the causality of early menopause, particularly natural menopause, and cardiovascular risks in women with endometriosis could help medical professionals develop effective strategies for early prevention and new therapies. Endometriosis, early menopause, and cardiovascular risks may be linked by primary or secondary mechanisms. Primary mechanisms involve shared pathways that can lead to all morbidities, while secondary occur due to delayed consequences of management strategies. In these large-scale cohort studies, relevant risk and confounding factors, such as oophorectomy, were considered to refine estimates of associations. However, none of the studies considered endometriotic cystectomy, a globally accepted treatment for endometriosis-associated pelvic pain and infertility, as a mediating factor. There is substantial evidence to indicate that endometriotic cystectomy harms ovarian reserve and may lead to early menopause in cases of multiple surgeries or bilateral cases. Early menopause is a well-established risk factor for cardiovascular disease. To thoroughly examine the link between endometriosis and early menopause, particularly natural menopause, and their connection with cardiovascular risks, it is imperative to consider all the possible factors that may affect the results, such as endometriotic cystectomy. This will enable us to obtain the most accurate and adjusted hazard ratio.
摘要：
大规模研究表明子宫内膜异位症与更年期早期发病有关。最近针对腹腔镜诊断为子宫内膜异位症的女性的研究发现，早期自然绝经的病例有所增加。此外，最近的大规模队列研究发现子宫内膜异位症与心血管疾病(CVD)风险增加之间存在相关性.了解更年期提前的因果关系，特别是自然更年期，子宫内膜异位症女性的心血管风险可以帮助医疗专业人员制定早期预防和新疗法的有效策略。子宫内膜异位症,更年期提前,和心血管风险可能与主要或次要机制有关。主要机制涉及可以导致所有疾病的共同途径，而次要的发生是由于管理策略的延迟后果。在这些大规模的队列研究中，相关风险和混杂因素，比如卵巢切除术,被认为是为了完善对关联的估计。然而,没有一项研究考虑子宫内膜异位膀胱切除术，一种全球公认的子宫内膜异位症相关盆腔疼痛和不孕症的治疗方法，作为中介因素。有大量证据表明，子宫内膜异位膀胱切除术会损害卵巢储备，并可能导致多次手术或双侧病例的早期绝经。早期绝经是心血管疾病的一个公认的危险因素。为了彻底检查子宫内膜异位症和早期绝经之间的联系，特别是自然更年期，以及它们与心血管风险的联系，必须考虑可能影响结果的所有可能因素，如子宫内膜异位膀胱切除术。这将使我们能够获得最准确和调整的危险比。
