Changes in the length of the menstrual cycle before menopause can predict the risk of heart disease

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As women approach menopause, the length of the menstrual cycle often becomes longer. The timing of these changes could provide clues about a person’s risk of developing heart disease, according to a new study led by researchers at the University of Pittsburgh.

Recently published in the journal Menopause, the study looked at changes in cycle length during the menopausal transition, finding that women whose cycle increased in duration two years before the final menstrual period maintained significantly better vascular health than those who had longer periods. stable cycle during this transition.

“Cardiovascular disease is the no. 1 killer of women, and the risk increases significantly after middle age, which is why we believe that menopause could contribute to this disease,” said lead author Samar El Khoudary, PhD and associate professor of epidemiology at Pitt’s Graduate School of Public Health.

On average, the menstrual cycle is about 28 days, but this period can vary greatly among women. Women with frequent short cycles have longer estrogen levels compared to those with fewer long cycles, and this variation in hormone levels could explain why long, irregular cycles during the reproductive years have been linked to cardiovascular disease, breast cancer, osteoporosis and other conditions.

El Khoudary and her team wondered if changes in cycle length during the menopausal transition could also predict future cardiovascular health. To answer the question, researchers analyzed data from 428 participants enrolled in the Women’s Health Study Nationwide. It followed women aged 45 to 52 at the time of enrollment for up to 10 years or until post-menopausal. The researchers collected data about the menstrual cycle during the menopausal transition and assessed cardiovascular risk after menopause by measuring arterial stiffness or artery thickness.

Finally, three distinct trajectories along the length of the menstrual cycle during the menopausal transition were noted. Approximately 62% of study participants had stable cycles that did not change significantly before menopause, while approximately 16% and 22% experienced an early or late increase, defined as an increase in cycle duration by five years or two years before the final menstrual period.

Thus, it was concluded that women in the late growth group had significantly more favorable values ​​in terms of hardness and thickness of arteries, indicating a lower risk of cardiovascular disease. At the same time, those in the early growth group had the weakest measures of arterial health.

“These findings are important because they show that we cannot treat women as one group: women have different menstrual trajectories during the menopausal transition, and this trajectory appears to be a marker of vascular health,” said El Khoudary.

Researchers hypothesize that the trajectory of the menstrual cycle during menopause reflects hormone levels, which in turn contributes to cardiovascular health. In future work, they intend to evaluate hormonal changes to test the 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 increase group. Although research suggests that high levels of estrogen may protect the heart in young women with short cycles, this hormone may be less protective in old age.

El Khoudary also wants to explore whether menstrual cycle patterns are linked to other cardiovascular risk factors, such as abdominal fat, which she previously found is associated with the risk of heart disease in menopausal women.

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