The association between menstrual symptoms and hypertension among young women: A prospective longitudinal study
Objectives: To investigate whether menstrual symptoms are associated with increased risk of hypertension among young women, and whether the relationship is bi-directional. Study design: We included 7729 women participating in the Australian Longitudinal Study on Women's Health, aged 22–27 years in 2000 and who were followed up every 3 years until 2015. Premenstrual syndrome, painful (dysmenorrhoea), heavy (menorrhagia), and irregular menstrual periods over the previous 12 months were self-reported and recorded as ‘never’, ‘rarely’, ‘sometimes’, or ‘often’. Questions regarding physician-diagnosed hypertension were asked, specifically for other than during pregnancy (defined as chronic hypertension) and during pregnancy (hypertensive disorder in pregnancy, HDP). Longitudinal data were analysed with generalised estimating equation time-lagged models to estimate relative risks (RRs) and 95 % confidence intervals (CI), adjusted for time-varying covariates. Mian outcome measures: Chronic hypertension, HDP, and menstrual disorders. Results: Over 15 years of follow-up, 757 women (9.8 %) reported having been diagnosed with chronic hypertension. Among 4473 parous women, 483 (10.8 %) reported a diagnosis of HDP. Women who often experienced heavy periods had an increased risk of incident chronic hypertension (RR 1.53, 1.13−2.09), compared with those who had not experienced heavy periods. We also found that women with chronic hypertension had an increased risk of incident heavy (RR 1.23, 1.02−1.50) and irregular periods (RR 1.42, 1.17−1.72). However, there was no apparent association between any menstrual symptoms and subsequent risk of HDP. Conclusions: The association between heavy periods (menorrhagia) and chronic hypertension may be bi-directional in young women. Chronic hypertension may also be associated with subsequent risk of irregular periods.