Duration of estrogen exposure during reproductive years, age at menarche and age at menopause, and risk of cardiovascular disease events, all‐cause and cardiovascular mortality: a systematic review and meta‐analysis

Mishra, Shiva Raj; Chung, Hsin‐Fang; Waller, Michael; Mishra, Gita D.

doi:10.1111/1471-0528.16524

Cited by 71 publications

(67 citation statements)

References 55 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…51 These data are consistent across recent prospective studies. 46,[52][53][54] Other reproductive health variables associated with stroke risk include parity and breastfeeding. Data on parity suggest elevated stroke among women with ≥5 live births compared with 1 or 2 live births, though in some studies, adjusting for confounding variables, particularly body mass index, eliminated this association.…”

Section: Female-specific Risk Factorsmentioning

confidence: 99%

The Impact of Sex and Gender on Stroke

Rexrode

Madsen

et al. 2022

Circulation Research

239

143

View full text Add to dashboard Cite

Women face a disproportionate burden of stroke mortality and disability. Biologic sex and sociocultural gender both contribute to differences in stroke risk factors, assessment, treatment, and outcomes. There are substantial differences in the strength of association of stroke risk factors, as well as female-specific risk factors. Moreover, there are differences in presentation, response to treatment, and stroke outcomes in women. This review outlines current knowledge of impact of sex and gender on stroke, as well as delineates research gaps and areas for future inquiry.

show abstract

Section: Female-specific Risk Factorsmentioning

confidence: 99%

The Impact of Sex and Gender on Stroke

Rexrode

Madsen

et al. 2022

Circulation Research

239

143

View full text Add to dashboard Cite

show abstract

“…However, only a few longitudinal studies have gone so far as to study associations between circulating sex hormone, sex hormone-binding globulin levels, and CVD, with varying results. 36 , 37 Moreover, as both menopause and biological aging are interrelated in time, the extent to which one contributes to age-related CV risk over the other is difficult to delineate. However, the question of a possible CV benefit from MHT has been promoted for decades, as noted in several observational studies such as the Nurse’s Health Study, which found postmenopausal hormone use to decrease risk for major coronary events in women without previous CVD.…”

Section: Menopause Hormone Therapymentioning

confidence: 99%

Cardiovascular risk in menopausal women and our evolving understanding of menopausal hormone therapy: risks, benefits, and current guidelines for use

Prabakaran

Schwartz

Lundberg

2021

Therapeutic Advances in Endocrinology

View full text Add to dashboard Cite

Women are at increased risk for cardiovascular disease (CVD) compared with men. While traditional risk factors for CVD seem to disproportionately affect women and contribute to this disparity, increased prevalence of CVD at midlife calls into question the contribution of menopause. Given the potential role that declining hormone levels play in this transition, menopause hormone therapies (MHT) have been proposed as a strategy for risk factor reduction. Unfortunately, trials have not consistently shown cardiovascular benefit with use, and several describe significant risks. Notably, the timing of hormone administration seems to play a role in its relative risks and benefits. At present, MHT is not recommended for primary or secondary prevention of CVD. For women who may benefit from the associated vasomotor, genitourinary, and/or bone health properties of MHT, CVD risks should be taken into account prior to administration. Further research is needed to assess routes, dosing, and formulations of MHT in order to elucidate appropriate timing for administration. Here, we aim to review both traditional and sex-specific risk factors contributing to increased CVD risk in women with a focus on menopause, understand cardiovascular effects of MHT through a review of several landmark clinical trials, summarize guidelines for appropriate MHT use, and discuss a comprehensive strategy for reducing CV risk in women.

show abstract

“…It seems intriguing that these two events in a woman’s reproductive life could be related. However, no consistent association between ages at menarche and menopause has been observed in epidemiological studies ( 2 , 48 , 49 , 50 , 51 ). This is further supported by newer genetic data revealing limited overlap in genomic regions associated with the timing of the two events ( 52 , 53 ).…”

Section: Discussionmentioning

confidence: 91%

Premature menopause and autoimmune primary ovarian insufficiency in two international multi-center cohorts

Vogt

Real

Husebye

et al. 2022

Endocrine Connections

View full text Add to dashboard Cite

Objective: To investigate markers of premature menopause (<40 years), and specifically the prevalence of autoimmune primary ovarian insufficiency (POI) in European women. Design: Postmenopausal women were categorized according to age at menopause and self-reported reason for menopause in a cross-sectional analysis of 6870 women. Methods: Variables associated with timing of menopause and hormone measurements of 17β-estradiol and follicle stimulating hormone (FSH) were explored using multivariable logistic regression analysis. Specific immunoprecipitating assays of steroidogenic autoantibodies against 21-hydroxylase (21-OH), side chain cleavage enzyme (anti-SCC) and 17alpha-hydroxylase (17 OH) as well as NACHT leucine-rich-repeat protein 5 (NALP5) were used to identify women with likely autoimmune POI. Results: Premature menopause was identified in 2.8% of women, and these women had higher frequencies of nulliparity (37.4% vs 19.7%), obesity (28.7% vs 21.4%), osteoporosis (17.1% vs 11.6%), hormone replacement therapy (59.1% vs 36.9%) and never smokers (60.1% vs 50.9%), (p<0.05), compared to women with menopause ≥ 40 years. Iatrogenic causes were found in 91 (47%) and non-ovarian causes in 27 (14%) women, while 77 (39%) women were classified as POI of unknown cause, resulting in a 1.1% prevalence of idiopathic POI. After adjustments nulliparity was the only variable significantly associated with POI (OR 2.46; 95% CI 1.63-3.42). Based on the presence of autoantibodies against 21 OH and SCC, 4.5% of POI cases were of likely autoimmune origin. Conclusion: Idiopathic POI affects 1.1% of all women and almost half of women with premature menopause. Autoimmunity explains 4.5% of these cases judged by positive steroidogenic autoantibodies.

show abstract

Duration of estrogen exposure during reproductive years, age at menarche and age at menopause, and risk of cardiovascular disease events, all‐cause and cardiovascular mortality: a systematic review and meta‐analysis

Cited by 71 publications

References 55 publications

The Impact of Sex and Gender on Stroke

The Impact of Sex and Gender on Stroke

Cardiovascular risk in menopausal women and our evolving understanding of menopausal hormone therapy: risks, benefits, and current guidelines for use

Premature menopause and autoimmune primary ovarian insufficiency in two international multi-center cohorts

Contact Info

Product

Resources

About