Premenstrual disorders may raise likelihood of early menopause, worse vasomotor symptoms

Key takeaways:

• More women with vs. without premenstrual disorders reported early menopause and moderate or severe vasomotor symptoms.
• There was no association between premenstrual disorders and mild vasomotor symptoms.

Women with premenstrual disorders may have increased likelihood for early menopause and moderate or severe vasomotor symptoms, according to a population-based cohort study published in JAMA Network Open.

“Premenstrual disorders, early menopause and vasomotor symptoms share risk factors, suggesting common etiologies. Specifically, an altered neuroendocrine system may contribute to the development of early menopause and vasomotor symptoms,” Yihui Yang, MPH, from the unit of integrative epidemiology at the Institute of Environmental Medicine at Karolinska Institute in Stockholm, and colleagues wrote. “Evidence also suggests that the interplay between the hypothalamic-pituitary-adrenal axis and the hypothalamic-pituitary gonadal axis may be associated with premenstrual disorders.”

Yang and colleagues conducted a population-based cohort study with data from the U.S. Nurses’ Health Study II on 1,220 women with premenstrual disorders (median age, 40.7 years) and 2,415 women without premenstrual disorders (median age, 41.7 years). Researchers analyzed menopause timing among women without natural or surgical menopause at baseline and analyzed vasomotor symptoms among women who reported symptoms.

The primary outcome was timing of natural menopause assessed through 2017 and vasomotor symptoms assessed in 2009, 2013 and 2017.

Median follow-up was 20.3 years. Compared with women without, those with premenstrual disorders were more likely to have a lower maternal education level (66.1% vs. 62.2%), have overweight (24.8% vs. 22%) or obesity (19.8% vs. 15.5%), smoke (9.9% vs. 6.1%), use oral contraceptives (87.3% vs. 78.1%), and to have experienced childhood abuse (78% vs. 63.6%), depression (47.8% vs. 21.4%) and anxiety (14.5% vs. 6.3%).

In the cohort, 17 women with premenstrual disorders and 12 women without reported early natural menopause (adjusted HR = 2.67; 95% CI, 1.27-5.59). More women with premenstrual disorders reported moderate or severe vasomotor symptoms compared with women without premenstrual disorders (68.3% vs. 55.3%; aOR = 1.68; 95% CI, 1.32-2.14).

In addition, researchers observed no association between premenstrual disorders and mild vasomotor symptoms (aOR = 0.99; 95% CI, 0.76-1.28).

“Together with the documented links between premenstrual disorders, early menopause and vasomotor symptoms, and hypertension and cardiometabolic diseases, future research on assessing health risks after menopause is warranted for this group even though premenstrual disorders end at menopause,” the researchers wrote.