Irregular Menstrual Cycle Linked to Cardiometabolic Conditions Regardless of PCOS Status: Daily Dose

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Last week, we reported on findings from a study published in JAMA Network Open that examined the association of polycystic ovary syndrome (PCOS) and irregular menstrual cycles with cardiometabolic conditions.

The study

Researchers conducted a cross-sectional study examining the associations of PCOS, time to regularity since menarche (adolescence), and irregular cycles (adulthood) with cardiometabolic conditions. They analyzed data from 60 789 women (mean age, 34.5 years; 71.4% White) who were enrolled in the Apple Women’s Health Study from November 2019 to December 2022 and met the following eligibility criteria: had ever menstruated, lived in the US, were aged at least 18 years, and were able to communicate in English.

Participants were asked to complete 5 surveys assessing medical and reproductive history, hormonal symptoms, and general health and lifestyle upon enrollment. Researchers restricted analyses to women who completed the demographics survey and at least 1 of the 4 remaining surveys.

The primary outcome was self-reported cardiometabolic conditions, including obesity, prediabetes, type 1 diabetes, type 2 diabetes (T2D), hypercholesterolemia, hypertension (HTN), metabolic syndrome, arrhythmia, congestive heart failure (CHF), coronary artery disease (CAD), myocardial infarction, heart valve disease, stroke, transient ischemic attack (TIA), deep vein thrombosis (DVT), and pulmonary embolism.

The findings

After researchers adjusted for all covariates (eg, age, race/ethnicity, socioeconomic status) they observed that PCOS was associated with a higher prevalence of all metabolic conditions, including obesity (prevalence odds ratio [POR] 2.94, 95% CI 2.77-3.12), prediabetes (POR 3.75, 95% CI 3.47-4.06), type 1 diabetes (POR 1.43, 95% CI 1.07-1.90), T2D (POR 2.76, 95% CI 2.43-3.15), hypercholesterolemia (POR 1.68, 95% CI 1.55-1.81), HTN (POR 1.57, 95% CI 1.45-1.70), and metabolic syndrome (POR 3.28, 95% CI 2.94-3.66), as well as cardiovascular conditions, including arrhythmia (POR 1.37, 95% CI 1.20-1.55), CAD (POR 2.92, 95% CI 1.95-4.29), heart attack (POR 1.79, 95% CI 1.23-2.54), stroke (POR 1.66, 95% CI 1.21-2.24), TIA (POR 1.87, 95% CI 1.44-2.40), DVT (POR 1.54, 95% CI 1.24-1.89), and pulmonary embolism (POR 1.83, 95% CI 1.43-2.32).

Among the 37 707 participants without PCOS, prolonged time to menstrual regularity was associated with a higher prevalence of prediabetes (POR 1.20, 95% CI 1.08-1.33), type 1 diabetes (POR 1.52, 95% CI 1.16-1.99), T2D (POR 1.24, 95% CI 1.05-1.46), HTN (POR 1.09, 95% CI 1.01-1.19), arrythmia (POR 1.20, 95% CI 1.06-1.35), and TIA (POR 1.33, 95% CI 1.01-1.73). Similarly, women without PCOS who reported having irregular cycles were more likely to have T2D (POR 1.36, 95% CI 1.08-1.69), hypercholesterolemia (POR 1.17, 95% CI 1.05-1.30), arrhythmia (POR 1.21, 95% CI 1.02-1.43), and TIA (POR 1.56, 95% CI 1.06-2.26).

Authors' comment

"While future studies with longitudinal data are warranted, our findings suggest the benefit of early intervention, such as weight management and exercise, that may help to alleviate cardiometabolic conditions among individuals with PCOS and/or irregular cycles.”

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