Menstrual Factors and Stroke Incidence in Japanese Postmenopausal Women: The Ohasama Study

Abstract

Background: The association between stroke and menstrual factors, for example, age at the time of menarche and age at the time of menopause, has not been well studied so far and the findings are inconsistent. We sought to examine this association in Japanese postmenopausal women. Methods: We followed 1,412 postmenopausal women aged ≥35 without a history of stroke in Ohasama, Japan. Baseline data were collected using a self-administered questionnaire. Adjusted hazard ratios (HRs) and 95% CIs of each menstrual factor for stroke incidence were calculated using the Cox proportional hazard model. Results: During a median follow-up of 12.8 years, 143 participants developed a stroke for the first time. Women aged ≤13 at the time of menarche had a significantly higher probability of encountering a stroke incidence in their lives compared with women aged 15 at the time of menarche (HR 1.83; 95% CI 1.04-3.22). The same was also true for cerebral infarction (HR 2.34; 95% CI 1.18-4.66). While early menopause was not significantly associated with stroke incidence, women aged ≤45 at the time of menopause faced a higher risk for cerebral infarction compared with women aged 50 years at the time of menopause (HR 3.25; 95% CI 1.54-6.86). Conclusions: Early menarche and its associated features might be a useful tool for future intervention strategies targeting modifiable factors that trigger menstrual onset.

Understanding the cultural meanings of stroke in the Ghanaian setting: A qualitative study exploring the perspectives of local community residents

“…An unexpected theme which emerged during the group discussions with young women was the mention of menstruation as a protective factor for stroke. This contradicts the findings from a study of 1,412 postmenopausal Japanese women ( Murakami et al ., 2016). The study showed that during the 12 year follow-up (1998–2010), menstrual factor such as early menarche was associated with incidence of stroke and cerebral infarction ( Murakami et al ., 2016).…”

“…This contradicts the findings from a study of 1,412 postmenopausal Japanese women ( Murakami et al ., 2016). The study showed that during the 12 year follow-up (1998–2010), menstrual factor such as early menarche was associated with incidence of stroke and cerebral infarction ( Murakami et al ., 2016). Since Murakami et al .…”

“…The study showed that during the 12 year follow-up (1998–2010), menstrual factor such as early menarche was associated with incidence of stroke and cerebral infarction ( Murakami et al ., 2016). Since Murakami et al . (2016)’s findings cannot be extrapolated to Ghanaian setting, this study recommends the need for future studies to explore the association between menstrual factors and stroke, especially in the five communities.…”

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

“…Overall, two studies found that earlier menarche was associated with higher risk of stroke after adjustment for age at menopause 4,19 . Of these studies, Alonso de Lecinana et al found that the odds of stroke were 54% higher among women aged <12 years at menarche compared with those aged 13 years at menarche 4 .…”

Is age at menarche associated with total mortality? The Troms&oslash; Study

“…Previous studies have shown an association between early AAM and earlier all-cause mortality, 5 cardiovascular mortality, 6 – 9 higher risk of breast cancer, 10 cardiovascular disease (CVD), 1 , 8 diabetes, 11 – 16 obesity 15 , 17 and metabolic syndrome. 15 , 18 – 21 Early AAM has also been associated with psychological disorders, depression, smoking and alcohol use in adolescence and early sexual behavior.…”