PMS linked to increased risk of heart disease

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.