This Article Full Text Full Text (PDF) Submit a related Letter to the Editor Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Solomon, C. G. Articles by Manson, J. E. Search for Related Content PubMed PubMed Citation Articles by Solomon, C. G. Articles by Manson, J. E.

Menstrual Cycle Irregularity and Risk for Future Cardiovascular Disease

Division of Women’s Health (C.G.S., A.D.), Division of General Medicine (C.G.S.), Channing Laboratory (F.B.H., M.J.S., W.C.W., F.E.S., J.E.M.), and Division of Preventive Medicine (J.E.M.), Department of Medicine, Brigham and Women’s Hospital; Departments of Nutrition (F.B.H., M.J.S., W.C.W.) and Epidemiology (M.J.S., W.C.W., J.E.M.), Harvard School of Public Health; and Department of Ambulatory Care and Prevention, Harvard Medical School (J.E.R.-E.), Boston, Massachusetts 02115

Address all correspondence and requests for reprints to: Dr. Caren G. Solomon, Division of Women’s Health, Brigham and Women’s Hospital, 75 Francis Street, Boston, Massachusetts 02115. E-mail . cgsolomon{at}bics.bwh.harvard.edu

Abstract

Cross-sectional studies suggest that women who have irregular menstrual cycles and hyperandrogenism may be at increased risk for cardiovascular disease (CVD). However, prospective data are lacking on the relationship between menstrual cycle irregularity and subsequent CVD risk. The objective of this study was to assess prospectively the risk for coronary heart disease (CHD) and stroke associated with a history of irregular menstrual cycles. The study design was a prospective cohort study of 82,439 female nurses who provided information in 1982 on prior menstrual regularity (at ages 20–35 yr) and were followed through 1996 for cardiovascular events. Incident reports of nonfatal myocardial infarction, fatal CHD, and nonfatal and fatal stroke were made. Medical records were reviewed for confirmation.

During 14 yr (1,155,915 person-yr) of follow-up, there were 1417 incident cases of CHD and 838 incident cases of stroke, including 471 cases of ischemic stroke. Compared with women reporting a history of very regular menstrual cycles, women reporting usually irregular or very irregular cycles had an increased risk for nonfatal or fatal CHD [age-adjusted relative risks (RR), 1.25 and 1.67, respectively; 95% confidence intervals (CI), 1.07–1.47 and 1.35–2.06, respectively]. Increased risks for CHD associated with prior cycle irregularity remained significant after adjustment for body mass index and several potential confounders. There was a nonsignificant increase in overall stroke risk (RR, 1.30; 95% CI = 0.97–1.74) and in ischemic stroke risk (RR, 1.40; 95% CI = 0.97–2.04) associated with very irregular cycles.

Menstrual cycle irregularity may be a marker of metabolic abnormalities predisposing to increased risk for CVD.

This article has been cited by other articles:

				C. A. Shively, T. C. Register, M. R. Adams, D. L. Golden, S. L. Willard, and T. B. Clarkson Depressive Behavior and Coronary Artery Atherogenesis in Adult Female Cynomolgus Monkeys Psychosom Med, July 1, 2008; 70(6): 637 - 645. [Abstract] [Full Text] [PDF]

				J. K. Snell-Bergeon, D. Dabelea, L. G. Ogden, J. E. Hokanson, G. L. Kinney, J. Ehrlich, and M. Rewers Reproductive History and Hormonal Birth Control Use Are Associated with Coronary Calcium Progression in Women with Type 1 Diabetes Mellitus J. Clin. Endocrinol. Metab., June 1, 2008; 93(6): 2142 - 2148. [Abstract] [Full Text] [PDF]

				J.-P. Baillargeon, J. E. Nestler, R. E. Ostlund, T. Apridonidze, and E. Diamanti-Kandarakis Greek hyperinsulinemic women, with or without polycystic ovary syndrome, display altered inositols metabolism Hum. Reprod., June 1, 2008; 23(6): 1439 - 1446. [Abstract] [Full Text] [PDF]

				R. Azziz Polycystic Ovary Syndrome Is a Family Affair J. Clin. Endocrinol. Metab., May 1, 2008; 93(5): 1579 - 1581. [Full Text] [PDF]

				J. E. Nestler Metformin for the Treatment of the Polycystic Ovary Syndrome N. Engl. J. Med., January 3, 2008; 358(1): 47 - 54. [Full Text] [PDF]

				N. Sattar and S. M. Nelson Polycystic Ovarian Syndrome, Biomarkers, and Metformin: Research, Risk, and Reality J. Clin. Endocrinol. Metab., January 1, 2008; 93(1): 34 - 36. [Full Text] [PDF]

				R. Shroff, A. Kerchner, M. Maifeld, E. J. R. Van Beek, D. Jagasia, and A. Dokras Young Obese Women with Polycystic Ovary Syndrome Have Evidence of Early Coronary Atherosclerosis J. Clin. Endocrinol. Metab., December 1, 2007; 92(12): 4609 - 4614. [Abstract] [Full Text] [PDF]

				C. Gagnon and J.-P. Baillargeon Suitability of recommended limits for fasting glucose tests in women with polycystic ovary syndrome Can. Med. Assoc. J., March 27, 2007; 176(7): 933 - 938. [Abstract] [Full Text] [PDF]

				G. Jasienska, M. Kapiszewska, P. T. Ellison, M. Kalemba-Drozdz, I. Nenko, I. Thune, and A. Ziomkiewicz CYP17 Genotypes Differ in Salivary 17-{beta} Estradiol Levels: A Study Based on Hormonal Profiles from Entire Menstrual Cycles. Cancer Epidemiol. Biomarkers Prev., November 1, 2006; 15(11): 2131 - 2135. [Abstract] [Full Text] [PDF]

				Z. T. Bloomgarden Third Annual World Congress on the Insulin Resistance Syndrome: Associated conditions. Diabetes Care, September 1, 2006; 29(9): 2165 - 2174. [Full Text] [PDF]

				J. M. Vink, S. Sadrzadeh, C. B. Lambalk, and D. I. Boomsma Heritability of Polycystic Ovary Syndrome in a Dutch Twin-Family Study J. Clin. Endocrinol. Metab., June 1, 2006; 91(6): 2100 - 2104. [Abstract] [Full Text] [PDF]

				S. Sam, R. S. Legro, P. A. Essah, T. Apridonidze, and A. Dunaif Evidence for metabolic and reproductive phenotypes in mothers of women with polycystic ovary syndrome PNAS, May 2, 2006; 103(18): 7030 - 7035. [Abstract] [Full Text] [PDF]

				G. Paradisi, A. Biaggi, R. Savone, F. Ianniello, C. Tomei, L. Caforio, and A. Caruso Cardiovascular Risk Factors in Healthy Women with Previous Gestational Hypertension J. Clin. Endocrinol. Metab., April 1, 2006; 91(4): 1233 - 1238. [Abstract] [Full Text] [PDF]

				M. Kravariti, K. K. Naka, S. N. Kalantaridou, N. Kazakos, C. S. Katsouras, A. Makrigiannakis, E. A. Paraskevaidis, G. P. Chrousos, A. Tsatsoulis, and L. K. Michalis Predictors of Endothelial Dysfunction in Young Women with Polycystic Ovary Syndrome J. Clin. Endocrinol. Metab., September 1, 2005; 90(9): 5088 - 5095. [Abstract] [Full Text] [PDF]

				B. Vural, E. Caliskan, E. Turkoz, T. Kilic, and A. Demirci Evaluation of metabolic syndrome frequency and premature carotid atherosclerosis in young women with polycystic ovary syndrome Hum. Reprod., September 1, 2005; 20(9): 2409 - 2413. [Abstract] [Full Text] [PDF]

				R. Azziz, C. Marin, L. Hoq, E. Badamgarav, and P. Song Health Care-Related Economic Burden of the Polycystic Ovary Syndrome during the Reproductive Life Span J. Clin. Endocrinol. Metab., August 1, 2005; 90(8): 4650 - 4658. [Abstract] [Full Text] [PDF]

				Z. T. Bloomgarden Second World Congress on the Insulin Resistance Syndrome: Mediators, pediatric insulin resistance, the polycystic ovary syndrome, and malignancy Diabetes Care, July 1, 2005; 28(7): 1821 - 1830. [Full Text] [PDF]

				C Svanes, F G. Real, T Gislason, C Jansson, R Jogi, E Norrman, L Nystrom, K Toren, and E Omenaas Association of asthma and hay fever with irregular menstruation Thorax, June 1, 2005; 60(6): 445 - 450. [Abstract] [Full Text] [PDF]

				D. S. Guzick Cardiovascular Risk in PCOS J. Clin. Endocrinol. Metab., August 1, 2004; 89(8): 3694 - 3695. [Full Text] [PDF]

				S. Taponen, H. Martikainen, M.-R. Jarvelin, U. Sovio, J. Laitinen, A. Pouta, A.-L. Hartikainen, M. I. McCarthy, S. Franks, M. Paldanius, et al. Metabolic Cardiovascular Disease Risk Factors in Women with Self-Reported Symptoms of Oligomenorrhea and/or Hirsutism: Northern Finland Birth Cohort 1966 Study J. Clin. Endocrinol. Metab., May 1, 2004; 89(5): 2114 - 2118. [Abstract] [Full Text] [PDF]

				N. Boulman, Y. Levy, R. Leiba, S. Shachar, R. Linn, O. Zinder, and Z. Blumenfeld Increased C-Reactive Protein Levels in the Polycystic Ovary Syndrome: A Marker of Cardiovascular Disease J. Clin. Endocrinol. Metab., May 1, 2004; 89(5): 2160 - 2165. [Abstract] [Full Text] [PDF]

				M. T. Sheehan Polycystic Ovarian Syndrome: Diagnosis and Management Clin. Med. Res., February 1, 2004; 2(1): 13 - 27. [Abstract] [Full Text] [PDF]

				T. L. Newton and C. L. Philhower Socioemotional Correlates of Self-Reported Menstrual Cycle Irregularity in Premenopausal Women Psychosom Med, November 1, 2003; 65(6): 1065 - 1069. [Abstract] [Full Text] [PDF]

				J. L. Sharpless Polycystic Ovary Syndrome and the Metabolic Syndrome Clin. Diabetes, October 1, 2003; 21(4): 154 - 161. [Abstract] [Full Text] [PDF]

				Z. T. Bloomgarden The Endocrine Society Meeting: Topics in Insulin Sensitivity and Hypertension Diabetes Care, September 1, 2003; 26(9): 2679 - 2688. [Full Text] [PDF]

				Z. T. Bloomgarden Diabetes Issues in Women and Children: Polycystic ovary syndrome Diabetes Care, August 1, 2003; 26(8): 2457 - 2463. [Full Text] [PDF]

				R. S. Legro Polycystic Ovary Syndrome and Cardiovascular Disease: A Premature Association? Endocr. Rev., June 1, 2003; 24(3): 302 - 312. [Abstract] [Full Text] [PDF]

				Z. T. Bloomgarden American Association of Clinical Endocrinologists (AACE) Consensus Conference on the Insulin Resistance Syndrome: 25-26 August 2002, Washington, DC Diabetes Care, April 1, 2003; 26(4): 1297 - 1303. [Full Text] [PDF]