Whether we say they are "capricious" or they occur "once every 36th of the month", irregular and / or spaced periods are the lot of a significant number of women (from 1 in 4 to 1 in 10 according to estimates).
Experienced as a fatality - or, conversely, as a logistical advantage - long cycles (more than 40 days) are still insufficiently the subject of medical concern.
However, they are the expression of a hormonal imbalance that can have significant repercussions on health in general: ovarian cancer, type 2 diabetes, coronary heart disease and mental illness have been associated with them.
To this list are added the findings of a study recently published in the
British Medical Journal
showing that women who had long cycles during their reproductive life had a higher risk of dying young (before age 70) than those who had regular cycles.
Read also:
Periods and painful intercourse: what if it was endometriosis?
This conclusion is based on the study of a cohort of more than 116,000 American nurses followed from 1989 to 2017. These women were asked to indicate whether they had had long and / or irregular cycles in adolescence, when they entered the hospital. adulthood and later (between 29 and 46 years).
These data were then compared with their medical history.
At the end of the study, nearly 2,000 early deaths were to be deplored, mostly due to cancer, then to cardiovascular disease.
Among the deceased, women who had long and / or irregular cycles (the two being very often combined) were over-represented, even taking into account other risk factors, such as diet and lifestyle.
The participants who reported very spaced (40 days and more) or anarchic periods had up to 40% more risk of dying young compared to volunteers with a normal regularity (26-31 days), in particular from an illness. cardiovascular.
The likelihood of dying from cancer was also higher in these people, but to a slightly lower extent.
A marker of general health
"Our study suggests that the characteristics of a woman's menstrual cycle are a non-specific marker of her overall health,"
Dr. Jorge Chavarro, of the TH Chan Institute of Public Health at Harvard, who led the
Figaro
told
Le Figaro
. study.
Therefore, the doctors she sees should, faced with long or irregular cycles, ask themselves what is the cause and if there is something to be done about it. "
Irregular periods are often the hallmark of polycystic ovary syndrome, which affects 10% of the female population.
But not only.
“In fact, the majority of women who have irregular or long cycles do not have PCOS
,” says Jorge Chavarro.
This is only part of the phenomenon. ”
"The anarchic cycles, spaced or very close together are the mark of a dysfunction of the axis which controls the production of hormones by the ovary, including the cerebral structures which are the hypothalamus and the pituitary gland",
explains Pr Geneviève Plu-Bureau, medical gynecologist at Cochin-Port-Royal hospital (Paris, APHP).
Hormonal treatment
In PCOS, women have excess testosterone
"which is known to have metabolic implications"
, such as an increased risk of insulin resistance or abdominal obesity, or even type 2 diabetes and, for example, extension, cardiovascular disease.
However, estrogen-progestogen-type hormonal treatment can regulate cycles and minimize metabolic risk.
"Another hypothesis not mentioned in the study would be that women with cycle disorders produce insufficient estrogen, which leads to premature aging of the vessels"
, continues Geneviève Plu-Bureau.
More generally, nurses who reported irregular or missed periods were more overweight and more likely to have high blood pressure and high cholesterol.
"So many risk factors for infarction and stroke",
translates Professor Claire Mounier-Véhier, cardiologist, co-founder of Agir pour le cœur des femmes.
“This study is very interesting because it is the first to show a link with early mortality,
” she notes
.
This will therefore be a new question to ask during the cardio-gynecological consultations that we have set up at the Lille University Hospital and aim to generalize in France.
In particular, we ask patients about their hormonal history - contraception, pregnancies, age of first menstruation - to assess their cardiovascular risk and implement appropriate prevention as soon as possible. ”
Few consultations
Losing weight, practicing
"sweaty"
physical activity
, reducing alcohol and salt consumption, and quitting smoking are all habits that can improve individual prospects and should even be taken in adolescence. And while it's normal to experience cycle oddities for the first two years after your first period, the persistence of unpredictable or 40 days or more spaced periods should be an alert.
“Irregular cycles are always the mark of a hormonal anomaly
, insists Prof. Sophie Christin-Maitre, head of the endocrinology department at Saint-Antoine hospital in Paris (APHP).
Yet few women consult just for that. The subject is approached indirectly, when they ask for contraception or if their period is painful. We even still see, in 2020, 30-year-old women with this kind of menstruation and who have never been evaluated for it. A period disorder in a woman outside of pregnancy should at least lead to a blood test for hormonal testing. "
