Age of Menstruation Onset Influences Heart Disease Risk

The age of menstrual cycle onset may influence women’s risk for developing heart disease, stroke and complications of high blood pressure (BP), according to a study published in Circulation.

Women who had their first menstrual cycle at age ≤10 years or age ≥17 years had the highest risk for developing these conditions; women who had their first menstrual cycle at age 13 had the lowest risk.

The study included data from 1.3 million women aged 50 to 64 years. After eliminating women who had prior histories of heart disease, stroke or cancer, the researchers analyzed the data from the remaining 1.2 million women. 

During an average follow-up of 11.6 years, they looked at first hospitalizations or deaths from coronary heart disease (CHD), stroke and hypertension. Results were adjusted for birth year, BMI, height, smoking status, alcohol consumption, exercise frequency and socioeconomic status.

Out of the 1.2 million women, 24.5% had their first menstrual cycle at age 13, 3.9% at age 10 or younger and 1.4% at age 17 or older. Women who had their first cycle at age 13 had the lowest risk for CHD; those who had their first cycle at a relatively young or old age had the highest risk. 

Compared with the age 13 onset group, the age ≤10 onset group was 27% more likely to develop CHD, and the age ≥17 onset group was 23% more likely.

The researchers also found that the early and late onset groups had increased risks for stroke and hypertension, though these risks were lower than for CHD. Compared with the age 13 onset group, the age ≤10 onset group had a 16% increased risk for stroke; the age ≥17 onset group had a 13% increased risk. 

The study also demonstrated a link between earlier menstrual cycle onset and higher BMI in adulthood, though the link between CHD and menstrual cycle onset remained the same after adjusting for BMI.

“Childhood obesity, widespread in many industrialized countries, is linked particularly to early age at which the first menstrual cycle occurs,” researcher Dexter Canot, MD, PhD, of the University of Oxford in the United Kingdom, said in a press release. “Public health strategies to tackle childhood obesity may possibly prevent the lowering of the average age of first menstrual cycle, which may in turn reduce their risk of developing heart disease over the long term.”

Although previous studies have linked earlier menstrual cycle onset with an increased risk for CHD, this study was the first to show an increased risk with late onset as well.