A new study has found that women with endometriosis may have a 46% higher risk of developing type 2 diabetes, compared to women without the condition in which the tissue similar to the lining of the uterus grows outside.

Endometriosis causes severe pelvic pain, painful periods and fertility challenges.

Researchers, led by those at the George Mason University in the US, followed nearly three million women in the Utah Population Database between 1996 and 2021, including nearly 100,000 diagnosed with endometriosis.

"Endometriosis was associated with a 46% higher risk of type 2 diabetes compared with no endometriosis," the authors wrote.

The team found that diabetes risk varied across different forms of endometriosis, suggesting the condition may have broader long-term health implications than previously recognised.

Chronic inflammation in endometriosis could be contributing to the development of insulin resistance and type 2 diabetes, even as more studies will be important for clarifying biological pathways underlying the observations, according to findings published in the journal Diabetologia.

"Previous studies largely evaluated endometriosis as a single condition and generally reported little or no overall association with type 2 diabetes," lead author Fuzak Nunziato, from George Mason University's college of public health, said.

"Our findings add to a growing understanding that endometriosis may affect more than reproductive health alone," Nunziato said.

The association between endometriosis and a higher diabetes risk was strongest among premenopausal women and women without obesity -- groups not traditionally considered at the highest risk for type 2 diabetes, the researchers said.

Further, certain forms of endometriosis were found to have a much stronger association with diabetes, compared to others. The link was greatest among women with extra-pelvic endometriosis, meaning the disease is found outside the pelvis.

The findings, if confirmed by future research, could help clinicians identify women with endometriosis potentially at a higher risk for type 2 diabetes and who could benefit from an earlier screening or prevention efforts, the researchers said.