Introduction to Premenstrual Disorders and Heart Disease
Premenstrual disorders are associated with a higher risk of developing cardiovascular disease, a large, long-term study has found. New research analyzing patient health data from more than 3 million women in Sweden over a 20-year period found that those who were diagnosed with premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD) had an 11% higher risk of developing cardiovascular disease at some point, compared to women who did not have a diagnosis.
Understanding the Risk Factors
Younger women who experienced a premenstrual disorder before age 25 had an even stronger risk of developing heart disease, 24%. Heart disease is the leading cause of death in women in the U.S. “It’s another reminder of taking care of your cardiovascular health when you’re young and not waiting until you’re in your 50s or later,” Elizabeth Bertone-Johnson said, study co-author and professor of epidemiology at the University of Massachusetts-Amherst.
Diagnosis and Symptoms
In order to be diagnosed with PMS or the more intense PMDD, symptoms such as mood swings, fatigue, cramping and food cravings need to be “bad enough” to be rated as “moderate” or “severe,” or have a significant impact on a patient’s ability to function, Bertone-Johnson said.
Subtypes of Cardiovascular Disease
The researchers analyzed subtypes of cardiovascular disease, including heart failure, arrhythmias and irregular heartbeat. An arrhythmia occurs when the heart’s electrical signals misfire, making the heart beat too quickly or too slowly. Arrhythmias and ischemic heart disease, damage caused by plaque which has built up in the coronary arteries, showed the strongest associations with PMS and PMDD.
Possible Reasons Behind the Link
Although the research did not study the possible reasons behind the link, Bertone-Johnson and other experts believe that premenstrual disorders might indicate other underlying physiological conditions. “Eventually it will show up as cardiovascular disease, but before that, it shows up in premenstrual symptoms,” Bertone-Johnson said. These conditions can include inflammation and alteration of the renin-angiotensin-aldosterone system — a hormonal system that regulates blood pressure, Dr. Nieka Goldberg, a cardiologist who specializes in women’s health at NYU Langone, said.
Accounting for Other Risk Factors
Even accounting for other cardiovascular risk factors such as smoking, weight, medication usage and some pre-existing conditions, women who had been diagnosed with a premenstrual disorder were more likely to develop heart problems. Researchers in Sweden also analyzed pairs of sisters as a way of accounting for genetic and environmental factors.
Limitations of the Research
There are limitations to the research. Bertone-Johnson said they looked only at women who had a clinical diagnosis of a premenstrual disorder and, because the population was based in Sweden, the patients were likely mostly white. Dr. Priya Jaisinghani, an endocrinologist at NYU Langone, thinks there should be more focus on women’s risk factors for heart disease, which can include reproductive, hormonal and metabolic conditions.
Implications of the Study
This study as well as others suggest a link between PMS and/or PMDD and hypertension, or high blood pressure. Still, high blood pressure is often underdiagnosed in women, according to the Office of Women’s Health. Goldberg said that one of the most important implications of this study is how it may pave the way for diagnosis of cardiovascular disease in younger patients. “This is a great step to early identification of women at risk for heart disease earlier in life,” she said. “Although the mechanism for heart disease risk in premenstrual disorders will need further study, it is important for doctors to get a complete menstrual history, including the presence of PMD in their patients.”
Conclusion
The study highlights the importance of considering premenstrual disorders as a potential risk factor for cardiovascular disease in women. By understanding the link between these disorders and heart disease, healthcare providers can take steps to identify women at risk and provide early interventions to prevent or mitigate the development of cardiovascular disease.
FAQs
Q: What is the relationship between premenstrual disorders and heart disease?
A: Premenstrual disorders, such as PMS and PMDD, are associated with a higher risk of developing cardiovascular disease.
Q: What is the increased risk of heart disease for women with premenstrual disorders?
A: Women with premenstrual disorders have an 11% higher risk of developing cardiovascular disease, and younger women who experience these disorders before age 25 have a 24% higher risk.
Q: What are the potential underlying physiological conditions that may contribute to the link between premenstrual disorders and heart disease?
A: Inflammation and alteration of the renin-angiotensin-aldosterone system, a hormonal system that regulates blood pressure, may contribute to the link between premenstrual disorders and heart disease.
Q: Why is it important for doctors to get a complete menstrual history, including the presence of PMD, in their patients?
A: Getting a complete menstrual history can help doctors identify women at risk for heart disease earlier in life and provide early interventions to prevent or mitigate the development of cardiovascular disease.
