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Women whose menstrual cycle was shorter than 22 days or longer than 34 days were more likely to have heart disease 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 results are interesting and highlight the importance of the menstrual cycle as a marker of health, especially heart health, explains Stephanie Faubion, MD, the director of the Center for Women’s Health at the Mayo Clinic in Jacksonville, Florida.
Irregular menstrual cycles are ‘not necessarily benign’
“This study adds to the accumulating literature that irregular menstrual cycles are not necessarily benign,” says Dr. Faubion, who is also medical director of the North American Menopause Society and was not involved in the study. ‘study. “Previous studies have linked irregular periods to multiple risk factors for cardiovascular disease, including insulin resistancehypercholesterolemia, high blood pressure and chronic inflammation. »
How long is a “regular” menstrual cycle?
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 generally considered regular. A longer or shorter cycle is considered irregular and affects about one in five women, according to Merck Manual.
A regular menstrual cycle length reflects the normal functioning of connected hormonal systems – among the hypothalamus, pituitary glandand ovaries – and is a vital indicator of overall health, according to the authors.
Irregular cycle length was associated with a 40% higher risk of atrial fibrillation
The researchers used data from nearly 60,000 women enrolled in the UK Biobank to investigate the link between menstrual cycle length, overall heart disease and specific cardiovascular events in women. The researchers defined a regular cycle length between 22 and 34 days.
At the time of enrollment, participants had an average age of 46, were 92 percent white, heart disease-free, and pre-menopausal. Health data was collected during four follow-up visits that took place from 2006 to 2010, from 2012 to 2013, and in 2014 and 2019.
During a median follow-up period of 12 years, 1,623 cardiovascular events occurred, including coronary artery disease, heart attack, atrial fibrillationstroke and heart failure.
Key findings of the study included:
- A menstrual cycle shorter than 21 days or longer than 35 days was associated with a 19% increase heart disease risk and 40% more risk of atrial fibrillation than a regular menstrual cycle length.
- Shorter menstrual cycles were associated with a 29% higher risk of cardiovascular events, including coronary heart disease, heart attack, atrial fibrillation, stroke and heart failure. Longer menstrual cycles were associated with an 11% higher risk of these cardiovascular events, compared to menstrual cycles of regular length.
- Shorter menstrual cycles were associated with a 38% higher risk of atrial fibrillation, and longer menstrual cycles were associated with a 30% higher risk of atrial fibrillation, compared to menstrual cycles of regular length.
- The researchers found no link between the length of the menstrual cycle and an increase stroke risk or heart failure.
These increased risks of cardiovascular disease were observed even after the researchers controlled for many factors that could influence the results, including age, ethnicity, body mass index, smoking, consumption of alcohol, physical activity, baseline cholesterol levela history of high blood pressure or type 2 diabetes, a history of using oral contraceptives or hormone replacement therapy, and a family history of heart disease or stroke.
Findings highlight the importance of monitoring menstrual cycles
Given these findings, women with irregular menstrual cycles should be made aware of their potential for increased risk of heart disease, the lead author said, Huijie Zhang, MD, Ph.D.chief physician and 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 attacks in women and underscore 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 leading cause of death in womenwith around one in five deaths caused by heart disease.
The study had some limitations. Menstruation data was self-reported by participants, and researchers could not rule out the dysregulatory effect of menopausal transition on menstrual cycles. Because the participants were nearly all white, the results may not be generalizable to women of diverse racial or ethnic backgrounds or to younger women.
Stressing the body can cause irregular periods
These findings make sense and support the fact that irregular periods are a marker of poor cardiovascular health, Faubion says. “Women can have irregular periods for a number of reasons, but among them are over-exercise, restrictive eating habits and high stress levels,” she says.
Although the association found in the study makes sense, the length of the menstrual cycle itself is unlikely to be 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 is likely the underlying cardiometabolic health issues causing the abnormal length of the menstrual cycle that are to blame. However, in either case, we can use this information to target lifestyle interventions to this population,” says Dr. Sanghavi.
Reproductive health history is an important part of a cardiac risk assessment
This study adds to a growing body of evidence that a reproductive health history is an important part of assessing a woman’s cardiovascular health, Sanghavi says.
“For a long time, women’s reproductive health lived on an island apart that only obstetricians and some primary care physicians went to. However, as cardiologistI believe we need to start building bridges to the island and integrating reproductive health assessment, including menstrual cycle history, pregnancy history and menopause, as part of a full assessment for women – otherwise we’re really not looking at the whole patient,” she says.
Although more research is needed, these findings could be used to start a conversation with women about heart disease prevention and identify risk factors that can be treated or modified, says Nieca Goldberg, MDMedical Director of Atria New York City and Clinical Associate Professor of Medicine at NYU Grossman School of Medicine.
Know your numbers and follow lifestyle programs designed to improve eating habits, promote regular exercise, stop smokingreducing stress and improving sleep are important strategies for preventing heart disease, says Dr. Goldberg.
Not sure if your cycle is regular? There is an application for that
There are many apps available to help you track your period. But these apps also collect a lot of data about you, and some experts worry about lax privacy practices of certain companies. consumer reports recommends period tracking apps Drop, WaitAnd Periodic for their superior privacy practices.
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