How often is an irregular menstrual cycle associated with cardiovascular disorders?

I’ve read that longer or shorter than average menstrual cycles may be linked to a higher risk of heart disease – is this true? What are the criteria to understand if the cycle is normal or not?

He replies Paolo Vercellinidirector of Gynaecology, Ospedale Maggiore Policlinico in Milan

The normal length of the menstrual cycle, that is, the period of time between the start of two successive flows, varies 22 to 34 days. Cycles of shorter or longer duration are defined as «irregular». A large study was conducted in the United Kingdom on 58,056 women, with the aim of verifying the existence of associations between the regularity and length of the menstrual cycle and some cardiovascular events. The women, with an average age of 46 at recruitment, were followed for approximately twelve years.

Irregular cycles

Compared to women with regular cycles, those with irregular cycles were at increased risk of cardiovascular disease and atrial fibrillation, a particular cardiac arrhythmia. Furthermore, women with short cycles were more affected by ischemic heart disease and myocardial infarction. Other data from the United Kingdom, concerning over 700 thousand patients followed for 26 years, confirm that cycle irregularity is associated with a greater risk of hypertension, diabetes, cardiovascular and cerebrovascular diseases.

Cardiovascular diseases

A study conducted on approximately 80 thousand American nurses, followed for 24 years, also highlighted this an increased risk of cardiovascular disease in women with irregular cycles, especially if they are excessively long. The same study had previously shown that women with irregular and long cycles were at slightly increased risk of death before age 70, mainly from cardiovascular causes.

Polycystic ovary syndrome

The increase in probability observed in all studies is generally small and it has not always translated into increased mortality. Furthermore, the cause is not to be found in the cycle anomalies per se, but in other conditions, such as polycystic ovary syndrome, which can determine its irregularity and constitute the true origin of endocrine-metabolic disorders associated with increased cardiovascular risk. A similar condition has also been observed in women with endometriosiseven in the absence of cycle irregularities.

Healthy eating

These data add to the evidence that overall demonstrates the impact of different reproductive factors on women’s cardiovascular health and underlines the importance of a healthy diet, regular exercise, abstention from smoking, weight reduction and timely recognition and treatment of dyslipidemia and hypertension.