A groundbreaking study published in the British Medical Journal (BMJ) Nutrition Prevention & Health reveals a concerning association between early menstruation and increased risks of type 2 diabetes and stroke in women. Conducted by researchers from Tulane University and Brigham and Women's Hospital in the US, the study analysed data from over 17,000 women aged 20 to 65, shedding light on the potential long-term health implications of early puberty.
The research establishes a strong link between initiating menstruation before the age of 13 and a heightened risk of developing type 2 diabetes in mid-life. Furthermore, the study uncovers that women who experienced early menstruation, particularly before the age of 10, face an elevated risk of stroke before reaching 65 if they develop diabetes.
While the observed associations are significant, the researchers emphasise the study's observational nature, highlighting the need for further investigation to establish causation. The study underscores the potential role of early menstruation as an early-life indicator of the cardiometabolic disease trajectory in women.
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Data from the nationally representative National Health and Nutrition Examination Survey (1999-2018) formed the basis of the study, with participants specifying the age of their first menstrual cycle. Of the women studied, 10% reported a diagnosis of type 2 diabetes, and 11.5% of these also reported some form of cardiovascular disease.
The increased risk of type 2 diabetes due to early menstruation was quantified at 32% for periods commencing at age 10 or before, 14% at age 11, and 29% at age 12. Additionally, menstruating before the age of 10 more than doubled the risk of stroke among women under 65 with diabetes.
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The researchers suggest that prolonged exposure to oestrogen and potential weight-related factors could contribute to these associations. The findings encourage the incorporation of age at the first menstrual cycle into early-life strategies for diabetes prevention and the management of diabetes complications. The study marks a crucial step in understanding the less-explored determinants of cardiometabolic risk in women, urging the design of interventional studies focusing on ethnically diverse groups who experience early menstruation.