Are menstrual disorders an indicator of premature mortality?

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Is there an association between menstrual regularity and life expectancy? A new article suggests answers. By Dr. Noga Shiffman

Over the years, the connection between various gynecological conditions and the general health of women becomes clearer. A study published in September 2020 in the British Medical Journal (BMJ) examined the association between the menstrual irregularity and premature mortality (before age 70).

The study was conducted in the United States, and included about 80,000 women, who were 25-42 years old at the beginning of the study, and followed them for 24 years. Women who reported an irregular menstrual cycle, or a difference of 40 days or more between periods (oligomenorrhea) – were found to be 30-40% more likely to die before the age of 70, for any reason (all cause mortality). These women were also found to be at increased risk for cardiovascular disease, which was the leading cause of death. This is compared to women who reported a regular menstrual cycle, and a cycle of 26-31 days.

Women who took birth control pills were included in a separate statistical analysis. Factors like body weight, BMI, exercise, and lifestyle, were also taken into account.

The authors of the article explain that menstrual regularity indicates the proper functioning of the hormonal axis between the hypothalamus gland, the pituitary and the ovaries. The connection is multidirectional, since hormonal dysfunction can cause metabolic diseases – and metabolic diseases can cause disorders of the hormonal axis. For example, the association between polycystic ovary syndrome, and type 2 diabetes is well known and broadly researched.

The results of the study demonstrate the value of questioning women about their menstruation, unrelated o gynecologic encounters, since it might be a marker for overall health. These findings should encourage women and healthcare providers to investigate the cause of irregular menstruation and oligomenorrhea. Physicians should asses other cardio-vascular risk factors such as diabetes, hypertension and high cholesterol, and emphasize a healthy diet and regular exercise.

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