The British Medical Journal (BMJ) Nutrition Prevention & Health published a US study suggesting a link between the onset of menstruation before the age of 13 and an increased risk of developing type 2 diabetes in mid-life. The research, conducted by Tulane University and Brigham and Women’s Hospital, also found that early menstruation, particularly before the age of 10, is associated with a higher risk of stroke before the age of 65 in individuals with diabetes. The study analyzed data from over 17,000 women aged 20 to 65, emphasizing that being an observational study prevented establishing the causes behind these associations.
Researchers utilized data from the National Health and Nutrition Examination Survey 1999-2018, with participants specifying the age of their first menstrual cycle. Approximately 10% of the women reported a diagnosis of type 2 diabetes, and of those, 11.5% reported some form of cardiovascular disease.
“Earlier age at [first menstrual cycle] may be one of early life indicators of the cardiometabolic disease trajectory in women,” they advised in their study.
“One potential pathway explanation may be that [such] women are exposed to oestrogen for longer periods of time, and early [menstruation] has been associated with higher oestrogen levels,” the researchers described.
The study revealed an increased risk of type 2 diabetes ranging from 32% (onset of periods at age 10 or before) to 14% (age 11) and 29% (age 12). Menstruating before the age of 10 was associated with over double the risk of stroke in women under 65 with diabetes. The calculated risk was 81% for those with their first period at age 11, 32% at age 12, and 15% at age 14.
“One potential pathway explanation may be that [such] women are exposed to oestrogen for longer periods of time, and early [menstruation] has been associated with higher oestrogen levels,” the researchers described.
The researchers acknowledged the potential influence of weight on the results, and when adjusting for weight, the associations between age at the first menstrual cycle and stroke complications weakened slightly but remained significant. They suggested that these findings could support the consideration of the age of first menstruation in early-life strategies for preventing diabetes and its complications.
“These findings add another dimension to the potentially less well understood determinants of cardiometabolic risk, particularly in women who have been relatively underrepresented in this area of research,” stated Sumantra Ray, Executive Director of the NNEdPro Global Centre for Nutrition & Health, which co-owns BMJ Nutrition Prevention & Health.
“And they provide a clear steer on the need to design interventional studies looking at the prevention of cardiometabolic disease in ethnically diverse groups of women who start menstruating at a young age,” he stated.
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