Women with irregular menstrual cycles are more likely to develop cardiovascular disease, such as heart attacks or atrial fibrillation, according to a new study published in the. Journal of the American Heart Association.
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The study of more than 58,000 women over 12 years found that longer or shorter menstrual cycles were associated with a higher risk of developing cardiovascular disease, heart attacks or atrial fibrillation (AF). Regular menstrual cycle length, defined as a cycle length of between 22 and 34 days, throughout a woman's reproductive life reflects the normal functioning of the connected hormonal systems between the hypothalamus, pituitary gland and ovaries, and is a key indicator of general health.
Irregular menstrual cycles are a common endocrine disorder, with about 20 percent of women experiencing long cycles or cycles of varying lengths, according to previous research. Previous studies have shown that irregular menstrual cycles are significantly related to multiple risk factors for heart disease, including insulin resistance, high cholesterol, high blood pressure, chronic inflammation and polycystic ovary syndrome.
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Other studies have shown that women have a higher risk of arrhythmias, or irregular heartbeats, due to hormonal fluctuations in the menstrual cycle. "The association between menstrual cycle characteristics and adverse cardiovascular outcomes remains unclear," said the senior author. Huijie Zhangchief physician and professor at Nanfang Hospital of Southern Medical University in China - considering the increasing prevalence of heart disease, which affects 45% of women in Western countries, and related mortality, these risk factors need to be explored."
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The UK Biobank
Researchers analyzed data from the UK Biobank to investigate whether menstrual cycle length was associated with overall heart disease and specific cardiovascular events in women.
The UK Biobank is a large database of health information for over 500,000 adults - enrolled from 2006 to 2010 - who receive care through the UK's National Health Service. This study included health data from 58,056 women with a mean age of 46 at the start of the study period, as well as no cardiovascular disease.
Health data were collected across four follow-up visits that took place from 2006 to 2010, 2012 to 2013, and in 2014 and 2019. Participants with menopause at study entry were excluded. The end of the study period was November 30, 2020, the most recent date for health data available for this analysis. During an average follow-up period of 12 years, more than 1,600 cardiovascular events were noted among the participants, including coronary artery disease, heart attack, atrial fibrillation, stroke, or heart failure.
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The analysis found menstrual cycles shorter than 21 days or longer than 35 days were associated with a 19% higher risk of heart disease as well as a 40% higher risk of atrial fibrillation. 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 – and longer menstrual cycles were associated with an 11% higher risk of these cardiovascular events, compared to menstrual cycles of regular duration.
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Irregular cycles and the heart
Menstrual cycle length was not associated with an increased risk of stroke or heart failure. These increased risks of cardiovascular disease were observed in women regardless of other risk factors, including age, race, BMI or body mass index, smoking status, alcohol intake, physical activity, baseline cholesterol levels, history of hypertension or type 2 diabetes, a history of using oral contraceptives or hormone replacement therapy, and a family history of heart disease or stroke.
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How to prevent
"Our analysis indicates that women with menstrual cycle dysfunctions may have negative consequences on cardiovascular health, therefore, we need to raise awareness that people with irregular menstrual cycles may be more likely to develop heart disease," said Zhang. important public health implications for the prevention of atrial fibrillation and stroke among women and underscore the importance of monitoring menstrual cycle characteristics throughout a woman's reproductive life."
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The study had several limitations, the researchers admit, including that its question about menstrual regularity was based on the participant's interpretation of irregular menstrual cycle length. The researchers could not rule out the potential impact of the menopausal transition on irregular menstrual cycles because data from participants at a younger age and including hormone levels were not available.