As women approach menopause, the length of their menstrual cycle tends to lengthen. The timing of these changes could provide clues to a person’s risk of developing heart disease, according to a new study led by researchers at the University of Pittsburgh.
The study, published in the journal Menopause , characterizes changes in cycle length during the transition to menopause. The results revealed that women whose cycle lasted in the two years before their last menstrual period had better vascular health measures than those who had stable cycles during this transition. In combination with other characteristics and health measures related to menopause, changes in cycle length could help doctors predict which patients may be at higher or lower risk for cardiovascular disease and recommend preventive strategies.
” Cardiovascular disease is the leading cause of death for women and the risk increases significantly after middle age, so we believe that menopause could contribute to this disease, ” explains Samar El Khoudary, associate professor of epidemiology at the School. Pitt’s Graduate School of Public Health and lead author of the paper. “Menopause does not occur at a specific time, as if a button were pressed. It’s a multi-stage transition in which women go through many changes that could put them at higher risk for cardiovascular disease. The change in cycle length, which is related to hormone levels, is a simple metric that could tell us who is at higher risk ”.
The average length of a menstrual cycle is approximately 28 days, but the variability is very high. Women with frequent short cycles spend more time with high estrogen levels compared to those with fewer long cycles, and this variation in hormone levels could explain why long and irregular cycles during the reproductive years have been linked to cardiovascular disease, breast cancer, osteoporosis, and other conditions.
This was the study
El Khoudary and his team wondered whether changes in cycle length during the menopausal transition could also predict future cardiovascular health. To answer this question, the researchers analyzed data from 428 participants enrolled in an ongoing study of women’s health in the United States. The study followed women ages 45 to 52 at enrollment for up to 10 years or until postmenopause. The researchers collected data on the menstrual cycle during the menopause transition and assessed cardiovascular risk after menopause by measuring arterial stiffness or the thickness of the arteries.
The researchers looked at three distinct trajectories in the length of the menstrual cycle during the menopausal transition. Approximately 62% of the participants had stable cycles that did not change appreciably before menopause, while approximately 16% and 22% experienced an early or late increase, defined as an increase in cycle length five years or two years before your last menstrual period, respectively.
Compared with women with stable cycles, those in the late augmentation group had significantly more favorable measures of artery hardness and thickness, indicating a lower risk of cardiovascular disease. Women in the early rise group had the worst measures of artery health.
Personalized prevention measures
“These findings are important because they show that we cannot treat women as one group: women have different trajectories of the menstrual cycle during the menopausal transition, and this trajectory appears to be a marker of vascular health,” said El Khoudary. . “This information adds to the set of tools we are developing for physicians who care for women in middle age to assess the risk of cardiovascular disease and brings us closer to customizing prevention strategies .”
Researchers hypothesize that menstrual cycle trajectories during menopause reflect hormone levels, which in turn contribute to cardiovascular health. In future work, they plan to evaluate hormonal changes to test this hypothesis.
According to El Khoudary, it is not clear why the risk of cardiovascular disease was higher in participants with stable cycles compared to the late rise group. Although research suggests that high estrogen levels can protect the heart in young women with short cycles, this hormone may be less protective in old age.
The Khoudary also wants to explore whether menstrual cycle patterns are linked to other cardiovascular risk factors, such as abdominal fat, which he previously found to be associated with heart disease risk in menopausal women.
Text: University of Pittsburgh
