What the Midlife Menstrual Cycle Says About Heart Risks Everyday Health MenuNewslettersSearch Menopause News Menstrual Cycle Length During Menopausal Transition May Predict Later Heart DiseaseIn the latest research linking a woman’s cycle to her overall well-being, data suggests cycle length provides important clues about cardiovascular health. By Meryl Davids LandauOctober 18, 2021Fact-CheckedThe number of days in a cycle may provide midlife women clues about their future health.Julia Kosickaya/iStockDoctors and scientists tend to lump women in the years before menopause into one bucket. But women experiencing perimenopause have distinct experiences, including how long they go between periods during this time of hormonal instability. It turns out the differing lengths may indicate more than just how many tampons a woman needs. New research shows cycle length may play a role in whether a woman has a higher risk of subsequently developing cardiovascular disease. RELATED: Causes and Risk Factors of Heart Disease The study, published online October 13, 2021, in Menopause, the journal of the North American Menopause Society (NAMS), found that women whose cycles were longer for more years during perimenopause were more prone to later cardiovascular problems. The Hormone Estrogen Protects a Woman s Heart Previous studies in younger women, when hormone levels on average are more stable, had already linked irregular menstrual cycles with certain health conditions, including cardiovascular disease risk, says the study’s lead researcher, Samar R. El Khoudary, PhD, MPH, an associate professor of epidemiology at the University of Pittsburgh. In addition, a cycle of more than 40 days (measured from the first day of bleeding to next month’s bleed) has previously been cited as a potential risk factor for type 2 diabetes in these younger women. RELATED: Menstrual Cycle Is Linked to Sleep Trouble, Study Suggests What Your Menstrual Cycle Says About Your Overall Health Cycle lengths are important because a woman with shorter cycles would have more ovulations each year, and therefore would likely have higher estrogen levels in her body. Estrogen has long been known to be important for protecting a woman’s heart. Other research in recent years has given doctors a clearer understanding of the links between aspects of menopause and the risk of future cardiovascular disease. They now know, for instance, that women who go through early menopause have a heightened risk, as do those experiencing more hot flashes. Since cycle length is a useful indicator in younger women, what about those in midlife? the researchers wondered. “A similar association had not been assessed in women transitioning through menopause who experience multiple changes that increase their risk for cardiovascular disease (CVD) later in life. Understanding risk factors for cardiovascular disease is important because this disease is the number one killer of women,” Dr. El Khoudary says. RELATED: Hormones and Your Health: An Essential Guide SWAN Is a Database of Midlife Women The Study of Women's Health Across the Nation (SWAN) is an ongoing multiethnic study of midlife women’s health. Some 3,300 women, ages 42 to 52 when they first enrolled in the study, participate at centers in seven cities across the country. Over the years, 16 follow-up visits have been completed. SWAN’s Daily Hormone Study was initiated in 1997, about two years into the SWAN study. As part of this initiative, researchers tracked menstrual cycle length and reproductive hormone levels across complete cycles, with measures repeated annually for up to 10 years or until the women pass menopause. The new study included 428 women who participated in SWAN. Within this group the researchers identified three cycle-length groups during the menopause transition, which they labeled stable (little change), late increase (more days between cycles coming in later years), and early increase (more days between cycles starting earlier). RELATED: Is Your Period Normal? The majority of women, some 62 percent, were found to have a stable trajectory — that is, their cycle length exhibited little change until close to menopause. Some 16 percent had cycles that lengthened early, as much as five years before their last period; 22 percent saw that increase later, closer to two years before menopause. As part of the study, the researchers also looked for early markers of atherosclerosis, such as the thickness inside the carotid artery that is used to determine the extent of hidden plaque. Then they looked for connections between the two. Among the three groups of women, those who experienced an early increase trajectory had the worst cardiometabolic risk profile, the researchers found. The Study Has Practical Implications for Women s Heart Health One takeaway from the research: “We cannot lump women together in one group; they experience different changes to their cycle during the menopause transition. Measuring these changes could be a simple way to predict who might be at risk of cardiovascular disease in the future,” El Khoudary says. RELATED: 12 Ways to Beat Menopausal Belly Fat A study coauthor, Rebecca Thurston, PhD, a professor of psychiatry, psychology, and epidemiology at the University of Pittsburgh, agrees that women should pay attention to how their cycle changes during perimenopause. “This study further underscores that the menstrual cycle is a key vital sign in women, in this case, yielding important information about their cardiovascular health,” she says. Doctors also need to pay more attention to this important marker, El Khoudary says. They should screen women for heart disease as aggressively as they screen men, especially those with longer cycle lengths during perimenopause. And they should help these patients adopt a heart-healthy lifestyle as early as possible. NEWSLETTERS Sign up for our Women' s Health Newsletter SubscribeBy subscribing you agree to the Terms of Use and Privacy Policy. 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