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Hormonal health

PMS linked to increased risk of heart disease

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Women diagnosed with premenstrual symptoms may face a higher risk of cardiovascular disease later in life, new research suggests.

A long-term study tracked more than 99,000 women with premenstrual symptoms for up to 22 years, comparing their outcomes with women who did not have such symptoms.

Researchers found that those affected had around a 10 per cent higher overall risk of developing cardiovascular disease, with particularly strong associations with stroke and heart rhythm disorders.

The study, led by researchers at Karolinska Institutet in Sweden, focused on women diagnosed with premenstrual syndrome (PMS) and the more severe premenstrual dysphoric disorder (PMDD). These conditions cause psychological and physical symptoms that typically begin a few days before menstruation and ease shortly after.

To account for genetic and environmental influences, the researchers compared affected women both with unrelated women and with their own sisters.

The analysis showed that women with premenstrual symptoms had a 31 per cent higher risk of developing heart rhythm disorders, known as arrhythmias, and a 27 per cent higher risk of stroke caused by a blood clot. These elevated risks remained even after adjusting for factors such as smoking, body mass index and mental health conditions.

“The increased risk was particularly clear in women who were diagnosed before the age of 25 and in those who had also experienced postnatal depression, a condition that can also be caused by hormonal fluctuations,” said Yihui Yang, PhD student at the Institute of Environmental Medicine at Karolinska Institutet and first author of the study.

The researchers suggested several possible reasons for the link. One is that women with premenstrual symptoms may have disrupted regulation of the renin-angiotensin-aldosterone system (RAAS), which helps control blood pressure and fluid balance. Another is that they may have higher levels of inflammation, a known contributor to atherosclerosis – hardening of the arteries – and other cardiovascular diseases. A third is the presence of metabolic abnormalities that increase the risk of stroke and heart attack.

“We hope that our findings will contribute to greater awareness that premenstrual disorders not only affect daily life but can also have consequences for long-term health,” said Donghao Lu, associate professor at the same department and last author of the study.

The findings suggest that women diagnosed with premenstrual disorders, particularly at a young age or those with a history of postnatal depression, may benefit from closer monitoring of their cardiovascular health.

News

Relaunched women’s health strategy aims to tackle ‘medical misogyny’

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Health secretary Wes Streeting has relaunched England’s women’s health strategy, vowing to stop women being “gaslit” by doctors.

Speaking before publication of the renewed strategy, the health secretary said the NHS was “failing women” and set out measures to help them access the healthcare they need.

The government said the strategy would include a new standard of care to ensure women were offered pain relief for invasive procedures, such as fitting a contraceptive coil and hysteroscopies.

Feedback would be directly linked to provider funding through a new trial, giving women more power to affect change if they have a poor experience.

Action would also be taken to ensure women no longer face long waits for diagnoses for conditions such as endometriosis, which can take a decade to diagnose.

Streeting said: “[Women] have for so long been let down by a healthcare system that too often gaslights women, treating their pain as an inconvenience and their symptoms as an overreaction.

“Whether it’s being passed from one appointment to another for conditions like endometriosis and fibroids, or a lack of proper pain relief during invasive procedures, through to having to navigate symptoms for years before receiving a diagnosis, it’s clear the system is failing women.

“Women’s voices must be central to delivering effective, respectful and empathetic care. We need to hit medical misogyny where it hurts – the wallet.

“Today’s renewed strategy will tackle the issues women face every day and ensure no woman is left fighting to be heard.”

A report last month by the women and equalities committee found that gynaecological and menstrual health had not been “sufficiently prioritised” by the government.

MPs said parts of the 10-year women’s health strategy, launched in 2022 by the Conservatives, were at risk of being scaled back or discontinued under wider changes to the NHS.

These included initiatives that had reduced waiting lists and improved women’s access to healthcare, such as women’s health hubs.

Sarah Owen, chair of the committee and a Labour MP, said: “This would be a disaster for girls’ and women’s menstrual healthcare, when it is in dire need of more support.

“It is a national scandal that nearly half a million women are on hospital gynaecology waiting lists when there are effective treatments that could be administered in primary and community care, if only they could access them.”

The report said women faced “medical misogyny” and were left to “suck it up” and suffer in pain for years because of a lack of awareness of women’s health conditions.

A redesign of clinical pathways for some women’s health issues will aim to speed up diagnosis and treatment, and there will be a review of support for families who experience repeated baby loss.

The government also promised a “single referral point” to ensure women were directed to the right place the first time they sought help.

Dr Sue Mann, NHS England’s women’s health director, said too many women were dismissed for “serious symptoms” that affected every part of their lives.

“The renewed women’s health strategy will build significantly on the work the NHS has been doing to ensure women are heard and get the specialist care they need,” she said.

Women’s health groups cautiously welcomed the renewed strategy. Emma Cox, chief executive of Endometriosis UK, said decisive action would be vital to improve women’s healthcare in England.

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Menopause

Watchdog bans five ads for women’s heath claims

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Five adverts for supplements claiming to treat menopause and other women’s health issues have been banned by the Advertising Standards Authority (ASA).

Ads for 222 Balance Me, Lunera, Minerva and Nova Menopause Vitality all claimed their products could prevent, treat or cure the symptoms of the menopause.

An advert and website for PolyBiotics implied its food supplements could prevent, cure or treat polycystic ovary syndrome, or PCOS.

ASA investigations manager Catherine Drewett said when it comes to women’s health, ‘people deserve clear and accurate information’.

She added: “Ads making misleading claims about treating symptoms of the menopause, PCOS and other hormonal conditions can cause real harm and today’s rulings hold advertisers to account.’

“We’ll continue to monitor this sector closely and we encourage anyone with concerns about an ad they’ve seen to get in touch.”

The ASA said it had taken a close look at adverts that might prey on people’s health worries, emotional concerns or financial pressures.

The regulator said it had used AI to analyse health claims in online adverts, which revealed emerging and ongoing issues around misleading claims and informed its rulings on the supplements.

The ASA said many of the claims in the adverts were ‘unacceptable’ and had not only broken a number of its rules but risked misleading vulnerable people, or steering those who needed it away from appropriate medical advice.

222 Collective accepted that wording in its adverts may have ‘inadvertently implied’ its product could ‘treat or relieve symptoms such as PMS, menopause-related symptoms, anxiety, bloating, heavy bleeding, or mood disorders’.

The company said it was a new, founder-run small business and still learning about the requirements of advertising regulations and was working with Trading Standards to ensure it did not make explicit or implied disease or symptom treatment claims.

Lunera said it accepted its claims would be understood by consumers to attribute a medicinal property to a food supplement and should not have appeared.

PolyBiotics told the ASA it accepted references to PCOS, ovulation, fertility, cycle regulation, insulin resistance and related symptoms constituted disease treatment or symptom-management claims, which were not permitted for food supplements.

Minerva and Nova did not respond to the ASA’s enquiries.

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Hormonal health

Non-hormonal menopause pill approved for NHS use

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A new daily menopause pill approved for NHS use could bring relief to women with debilitating hot flushes and night sweats.

Around 500,000 women are expected to be eligible for the treatment, which experts say could help those unable to take hormone replacement therapy, or HRT.

The drug, fezolinetant, also known as Veoza, is a daily non-hormonal tablet designed to target the brain signals that trigger some of the most disruptive menopause symptoms.

In final draft guidance published today, the National Institute for Health and Care Excellence recommended the 45mg tablet for women experiencing moderate to severe hot flushes and night sweats.

More than two million women in the UK are thought to suffer these symptoms during menopause, often beginning during the earlier stage known as perimenopause.

For many, the effects are severe, disrupting sleep, affecting concentration and straining relationships. In some cases women are even forced to cut back on work.

An estimated 60,000 women in the UK are currently out of work or on long-term sick leave due to severe menopause symptoms, costing the economy roughly £1.5bn a year.

Research also suggests one in 10 women has left the workforce entirely because of a lack of support.

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