Women whose period cycle was shorter than 22 days or longer than 34 days were more likely to experience cardiovascular disease….CONTINUE READING
events, including heart attack or atrial fibrillation (afib) , according to a new study published on May 24 in the Journal of the American Heart Association.
These findings are interesting, and they highlight the importance of the menstrual cycle as a marker of health, especially heart health, says Stephanie Faubion, MD ,
the director at the Center for Women’s Health at the Mayo Clinic in Jacksonville, Florida.
“This study adds to the accumulating literature that irregular menstrual cycles are not necessarily benign,” says Dr. Faubion, who also serves as the medical director for the North American Menopause Society and was not involved in the study. “Previous studies have linked irregular menses with multiple cardiovascular disease risk factors, including insulin resistance, high cholesterol, high blood pressure, and chronic inflammation.”
The menstrual cycle is counted from the first day of one period to the first day of the next period. The average total menstrual cycle is 28 days, and anything between 21 and 35 days is usually considered regular. A longer or shorter cycle is considered irregular, and is experienced by about one in five women, according to Merck Manual.
A regular menstrual cycle length reflects normal functioning of the connected hormone systems — among the hypothalamus, pituitary gland, and ovaries — and is a vital indicator of overall health, according to the authors.
Researchers used data from nearly 60,000 women enrolled in the UK Biobank to investigate the connection between menstrual cycle length, overall heart disease, and specific cardiovascular events in women. Researchers defined a regular cycle length as between 22 and 34 days.
At the time of enrollment, participants had an average age of 46, were 92 percent white, free of heart disease, and had not yet gone through menopause. Health data was collected through four follow-up visits that took place from 2006 to 2010, 2012 to 2013, and in 2014 and 2019.
During a median follow-up period of 12 years, 1,623 cardiovascular events occurred, including coronary heart disease, heart attack, atrial fibrillation, stroke, and heart failure.
Key findings from the study included:
These increased risks of cardiovascular disease were observed even after researchers controlled for many factors that could influence the findings, including age, ethnicity, body mass index, smoking status, drinking status, physical activity, baseline cholesterol levels , history of high blood pressure or type 2 diabetes, history of oral contraceptive use or hormone replacement therapy, and family history of heart disease or stroke.
Given these results, women with irregular menstrual cycle patterns should be informed about their potential for increased risk of heart disease, said the senior author, Huijie Zhang, MD, PhD, the chief physician and a professor at Nanfang Hospital of Southern Medical University in China, in a press release.
“These findings have important public health implications for the prevention of atrial fibrillation and heart attack among women and highlight the importance of monitoring menstrual cycle characteristics throughout a woman’s reproductive life,” said Dr. Zhang.
This is especially true given the prevalence of heart disease in Western countries, he added. In the United States, heart disease is the number one cause of death in women, with about one in every five deaths caused by heart disease.
The study had a few limitations. The data on periods was self-reported by participants, and researchers could not rule out the dysregulating effect of the menopausal transition
on menstrual cycles. Because the participants were nearly all white, the findings may not be generalizable to women from diverse racial or ethnic backgrounds or younger women.
These findings make sense and support the fact that irregular menses represent a marker for poorer cardiovascular health, says Faubion. “Women may have irregular menses for a number of reasons, but among them are overexercising, restrictive eating patterns, and high levels of stress,” she says.
Although the association found in the study makes sense, the menstrual cycle length itself is likely not the cause of the increased risk, says Monika Sanghavi, MD, the director of Women’s Cardiovascular Health at Penn Medicine in Philadelphia, who was not involved in the research. “Rather, it’s likely the underlying cardiometabolic health problems causing the abnormal menstrual cycle length that are to blame. However, either way, we can use this information to target lifestyle interventions in this population,” says Dr. Sanghavi.
This study adds to a growing body of evidence that reproductive health history is an important part of a woman’s cardiovascular health assessment, says Sanghavi.
“For a long time, women’s reproductive health has lived on an island of its own that only ob-gyns and some primary care physicians addressed. However, as a cardiologist, I believe we must begin to build bridges to the island and incorporate reproductive health assessment, including menstrual cycle history, pregnancy history, and menopause, as part of a comprehensive assessment for women — or else we are truly not caring for the whole patient,” she says.
Although more research is needed, these findings could be used to start a conversation with women on heart disease prevention
and identify risk factors that can be treated or modified, says Nieca Goldberg, MD
, the medical director of Atria New York City and a clinical associate professor of medicine at the NYU Grossman School of Medicine.
Knowing your numbers and following lifestyle programs designed to improve eating patterns, promote regular exercise, stop smoking , reduce stress, and improve sleep are important strategies to prevent heart disease, says Dr. Goldberg.
There are many apps available to help you track your periods. But these apps also gather a lot of data about you, and some experts are concerned about the lax privacy practices of some companies. Consumer Reports
recommends the period tracking apps Drip, Euki, and Periodical for their superior privacy practices….CONTINUE READING