A new study suggests that women with irregular menstrual periods or shorter cycles may be at a greater risk for cardiovascular disease.
According to the study published in the Journal of the American Heart Association on Wednesday, cycles that were shorter or longer than normal (less than 21 days) and irregular heartbeats (more than 35 days) are associated with an increased risk of cardiovascular diseases and atrial fibrillation. The number of days between menstrual periods was used to measure a menstrual cycle.
Researchers found that 'longer menstrual cycles are associated with an increased risk of atrial fibrillation, but not heart failure or stroke'. Shorter cycles were linked to a higher risk of coronary artery disease, myocardial ischemia, and heart attacks.
Some questions remain.
In an email, Dr. Huijie Zhang of Nanfang Hospital, Southern Medical University, China, who is the senior author of the study, explained that while 'women experiencing menstrual dysfunction may have adverse cardiovascular health effects,' it's unclear what exactly drives this relationship.
Zhang stated that the findings of the study indicate it is 'time' to increase awareness about the importance and monitoring of menstrual cycle traits throughout a woman's reproductive years.
According to the US National Institutes of Health, worldwide, between 14% and 25% of women experience irregular menstrual periods.
Researchers in China analyzed data from 58,056 British women. The women aged 40-69 reported on their menstrual cycle length, regularity, and other medical data over a period of 12 years.
Women reported 39,582 menstrual periods, while 18,474 women reported irregular or no menstrual cycles.
Researchers found that only 2.5% of women with regular periods developed cardiovascular disease compared to 3.4% for those with irregular cycles.
Researchers found that irregular menstrual cycles are associated with an increased risk of cardiovascular disease, despite other factors such as age, race, ethnicity, BMI and smoking status. They also noted that physical activity, alcohol consumption, and a history of oral contraceptive usage were all important.
Data also revealed that 0.56% with regular cycles had atrial fibrillation compared to 0.92% with irregular cycles.
Researchers found that approximately 1.3% of people with regular cycles had coronary heart disease compared to 1.7% of people with irregular cycles. Around 0.29% of those with regular cycles had heart attacks compared to 0.45% for those with irregular cycle.
Another vital sign
Dr. Stephanie Faubion of Mayo Clinic's Center for Women's Health, and medical director of North American Menopause Society, was not surprised by the findings.
The study was conducted by Faubion who did not take part in the study.
The American College of Obstetricians and Gynecologists issued a 2015 guideline that states medical practitioners should consider the menstrual cycles of adolescents to be an additional vital indicator. It should be used as a way to gauge overall health. Doctors should also try to identify any abnormal patterns of menstruation in adolescents.
Faubion stated that studies have found a link between irregular menstrual cycle and markers of heart disease risk, such as high cholesterol, insulin resistance, and chronic inflammation. But the reasons behind these associations are still unknown.
Faubion stated that although he did not know the exact mechanism, menstrual cycle should still be considered as a "marker" of overall health.
She said that if a woman is not menstruating regularly, her health care provider should investigate the reasons for this. Part of this involves educating healthcare professionals that menstrual cycle is another vital sign for woman.
The new study did not include Dr. Nieca GOLDBERG, medical director at Atria New York City, clinical associate professor in medicine at NYU Grossman Medical School, who is a cardiologist.
In an email sent on Wednesday, she said that studies have shown an association between shorter periods and insulin resistance as well as lipid abnormalities. However, the exact reasons for this are unknown.
Short cycles are linked to lower estrogen levels, which affect insulin resistance and lipid levels. Goldberg writes that the risk of atrial fibrillation may be related to hormonal changes, and their impact on electrocardiograms. It is evident that women need to continue research into the menstrual cycle in relation to cardiovascular risk. This shows we are not finished assessing cardiovascular disease risk factors in women.