Disclosures: The authors report no relevant financial disclosures.
December 16, 2021
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Irregular menses may signal heart disease, diabetes risk

Disclosures: The authors report no relevant financial disclosures.
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Women with irregular menses are 20% more likely to develop cardiovascular disease and 17% more likely to develop type 2 diabetes over 20 years compared with women with regular menstrual cycles, according to an Australian database analysis.

Links between menstrual disorders and metabolic conditions are often underappreciated and not considered when assessing cardiometabolic risk in women, Sylvia Kiconco, MSc, a doctoral student at Monash University School of Public Health and Preventive Medicine in Victoria, Australia, and colleagues wrote.

Risks for developing CVD and type 2 diabetes for women with irregular menstrual cycles.
Women with irregular menstrual cycles are more likely to develop CVD and type 2 diabetes than those with regular menstrual cycles. Data were derived from Kiconco S, et al. Clin Endocrinol. 2021;doi:10.1111/cen.14640.

“This limits screening and prevention strategies including lifestyle modification and becomes even more pertinent as women transition through menopause, which is associated with increased visceral adiposity and adverse cardiometabolic changes,” the researchers wrote. “Moreover, premature and early menopause are associated with chronic conditions including diabetes, hypertension, heart disease, stroke, chronic obstructive pulmonary disease, asthma, arthritis, osteoporosis, breast cancer, depression and anxiety.”

In a community-based longitudinal study, Kiconco and colleagues analyzed data from the 1946 to 1951 birth cohort database (n = 13,714) of the Australian Longitudinal Study on Women’s Health over a 20‐year follow‐up period. Researchers used Cox regression models to assess risk for diabetes and CVD among women self-reporting irregular menses vs. women with regular cycles.

Women with irregular menstrual cycles had a 20% higher risk for developing CVD, with an adjusted HR of 1.2 (95% CI, 1.01-1.43), as well as a 17% higher risk for developing type 2 diabetes (HR = 1.17; 95% CI, 1-1.38), compared with those with regular menstrual cycles. Diabetes risk was 30% higher (HR = 1.3; 95% CI, 1.09-1.55) if women had irregular cycles and did not use hormone therapy; however, the increased risk did not persist after adjustment for all covariates.

“Menstrual regularity is a correlate for long‐term cardiometabolic disease modulated by hormone use,” the researchers wrote. “This highlights the importance of screening for diabetes and heart disease as recommended in the most common conditions associated with irregular menstrual cycles in women in their 40s, such as polycystic ovary syndrome and early menopause.”

As Healio previously reported, an analysis published in The BMJ showed women reporting consistently long or irregular menstrual cycles are more likely to die of cancer or CVD compared with women who report regular menses. Compared with women reporting a “very regular” menstrual cycle, women were more likely to die before age 70 years when reporting always having an irregular or no period at age 14 to 17 years (HR = 1.18; 95% CI, 1.02-1.37), age 18 to 22 years (HR = 1.37; 95% CI, 1.09-1.73) and age 29 to 46 years (HR = 1.39; 95% CI, 1.14-1.7).