A women's menstrual cycle must be considered as a vital sign of assessing general health

A recent BMJ article suggests that the regularity of a women's menstrual cycle can present a greater risk of premature death. Previous research has long demonstrated the link between long and irregular periods and the increased risk of chronic diseases such as diabetes, cardiovascular disease and mental health problems. Few studies prior to this show the possible effect and possible link with irregular cycles to early mortality.

The findings in the study are based on data from 79,505 pre-menopausal women with an average age of 38. None had any history of chronic diseases and all were enrolled as part of the Nursing Study II which started in 1989 following US registered nurses between the ages of 25-42 years using electronic questionnaires which collect a variety of information such as diet, lifestyle, medical history and long term illness.


We know that regular periods reflect the normal functioning of the hypothalamic-pituitary-ovarian axis which is a vital sign of a women's health, think of the hypothalamic-pituitary-ovarian axis as tightly regulated system of 3 different parts, the hypothalamus located at the base of the brain, the pituitary gland located just below the hypothalamus and the ovaries located in a women's pelvis, these different parts all work together as a team to regulate the menstrual cycle. Irregular and longer periods are often attributed to the functional disruption of the hypothalamic-pituitary-ovarian axis.


The study found that women with irregular or long menstrual cycles in adolescence and adult life were more likely to die before the age of 70 than women who reported regular cycles. The research suggested that this was likely due to the disrupted hormonal environment. The study also found a joint effect of long cycle length and smoking on mortality, women with long or irregular cycles are already known to have an adverse cardiovascular and inflammatory risk profile which can be made worse by smoking.

The results highlight a need for menstrual history and cycle regularity to form a regular part of primary care consultations, health and well being, and as an indicator for overall general health for women, not just in adolescence but also throughout reproductive life. The study also points out the effects of lifestyle on overall health and the menstrual cycle such as smoking. This research emphasis the importance of providing personalised health care for women throughout all aspects of their lives. Long and irregular cycles are not uncommon, however there have been little research into their link with mortality, this study offers more insight and information.


Reference

Wang Y, Arvizu M, Edwards J, Stuart J, Manson J, Missmer S, Pan A, Chavarro J. (2020) Menstrual cycle regularity and length across the reproductive lifespan and risk of premature mortality: prospective cohort study; British Medical Journal (371) 3464




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