August 11, 2026, 6:20 pm | Read time: 4 minutes
Endometriosis is often associated with pain, infertility, or gynecological issues. However, the condition could also have implications for overall health. A large U.S. study involving nearly three million women investigated whether endometriosis increases the risk of type 2 diabetes.
Affected Individuals Have an Increased Risk
The main finding of the study is clear: Women with endometriosis had a 46 percent higher risk of developing type 2 diabetes over time compared to women without the condition. The link was particularly strong in certain endometriosis subtypes, especially rare forms outside typical locations.
How the Study Was Conducted
For the study, researchers from the U.S. analyzed health data from about 2.9 million women in the Utah Population Database. The participants were observed between 1996 and 2021, on average for nearly 11 years. The goal was to examine whether endometriosis overall and certain subtypes are associated with an increased risk of type 2 diabetes. Additionally, the researchers wanted to know if factors like BMI, menopausal status, or a history of gestational diabetes influenced this connection. The study results were published in the journal Diabetologia.1
Risk Depends on Endometriosis Type and Life Stage
During the observation period, nearly 100,000 women were diagnosed with endometriosis. Overall, the condition was associated with a significantly increased risk of diabetes.
The risk varied depending on the type of endometriosis. For superficial peritoneal endometriosis (on the peritoneum), it was 67 percent higher, and for ovarian endometriosis (on the ovaries), it was 61 percent higher. The strongest associations were found in endometriosis lesions outside the usual locations, where the risk was more than double that of women without endometriosis. The related condition adenomyosis was also linked to an increased diabetes risk.
In deep infiltrating endometriosis–the clinically most severe form, which penetrates deeper than five millimeters into the tissue and often affects adjacent organs–the diabetes risk increased by 45 percent.
The connection was particularly pronounced in premenopausal women and those with a BMI under 30. The results remained largely consistent in additional control analyses, strengthening the findings’ validity.
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Study Evaluation
The study’s strengths include the very large number of participants and the long observation period, allowing researchers to examine rarer forms of endometriosis and various subgroups.
A limitation is that diagnoses were primarily based on ICD codes, which could lead to misclassifications. Additionally, women with endometriosis might be examined more frequently, leading to earlier detection of type 2 diabetes compared to women without the condition. Although the authors attempted to counteract these potential biases with additional analyses, they cannot be completely ruled out.
Furthermore, there were no data on factors such as diet, physical activity, or hormonal treatments that could have influenced the results. The authors report no conflicts of interest. The study was funded in part by the U.S. National Heart, Lung, and Blood Institute.
Also of interest: Researchers discover surprising endometriosis clue
Further Studies on This Topic
However, the results of the current study are not without controversy. A large U.S. study as part of the Nurses’ Health Study II reached a different conclusion in 2021.2 Among 112,000 nurses followed for over 25 years, no overall increased diabetes risk from endometriosis was found. A key difference: Endometriosis was consistently confirmed via laparoscopy–the diagnostic gold standard. Notably, this study also found a slightly increased risk in slimmer women, a pattern the new study also identified, but much more pronounced.
Beyond diabetes, research suggests a broader impact on the metabolic and vascular systems. A meta-analysis from 2025 evaluated seven studies with around 1.4 million women.3 It found that women with endometriosis had a 35 percent higher risk of ischemic heart disease and a 19 percent higher risk of cerebrovascular diseases. Heart arrhythmias were also more common. However, no link was found for heart failure and mortality. Chronic inflammation, which characterizes the condition, is considered a possible common denominator–though this mechanism has not yet been proven.