Woman's Reproductive Period Tied to Type 2 Diabetes Risk

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Women with a reproductive history <30 years or >45 years had an increased risk of type 2 diabetes.
Women with a reproductive history <30 years or >45 years had an increased risk of type 2 diabetes.

Women who had a reproductive duration of less than 30 years or longer than 45 years may have an increased risk of type 2 diabetes compared with those who had a reproductive duration between 36 and 40 years, according to recent data published in Menopause.

Researchers used data from 124,379 women from the Women's Health Initiative aged 50 to 79 years. They recorded age of menarche and final menstrual period, a history of irregular menses from questionnaires at baseline, and calculated the reproductive length from age of menarche and final menstrual period.

“Our study found that both shorter and longer reproductive-duration lengths are associated with increased risk of type 2 diabetes,” the authors of the study wrote.  “This suggests that lifetime estrogen exposure may play a role in the development of type 2 diabetes—there may be an ‘optimal' amount of estrogen exposure for metabolic functioning, although exogenous estrogen may have different effects due to different route, dose, and timing of administration.”

Women who had reproductive periods shorter than 30 years had a 37% greater risk of developing type 2 diabetes (95% CI, 30-45) than women with medium-length reproductive periods, between 36 and 40 years.

The results also showed that women with the longest reproductive periods, greater than 45 years, had a 23% higher risk than women with medium-length reproductive periods (95% CI, 12-37).

Furthermore, women with a final menstrual period before age 45 (hazard ratio [HR], 1.04; 95% CI, 0.99-1.09) or after age 55 (HR, 1.08; 95% CI, 1.01-1.14) had an increased risk of diabetes compared with those with a final menstrual period between ages 46 and 55 years. After full adjustments, timing of menarche and cycle regularity were not associated with diabetes risk.

The results of the study suggest a potential public health concern for women whose reproductive history suggests they may be at greater risk for developing type 2 diabetes.

“The finding that both shorter and longer reproductive durations were associated with risk of diabetes has important implications for women with early or late menopause as well as for those with BRCA gene mutations considering risk-reducing bilateral oophorectomy that would shorten their reproductive time,” stated JoAnn V. Pinkerton, MD, executive director of The North American Menopause Society, in a press release.

“Given the high prevalence of diabetes in postmenopausal women, those with shorter and longer reproductive periods may benefit from lifestyle counseling. Future research should focus on ways to prevent type 2 diabetes in women at risk as they age.”

Reference

  1. LeBlanc ES, Kapphahn K, Hedlin H, et al. Reproductive history and risk of type 2 diabetes mellitus in postmenopausal women: findings from the Women's Health Initiative. Menopause. 2016;24(1). doi:10.1097/GME.0000000000000714.
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