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Menstrual cycle link to heart disease

Tuesday, 14 November, 2000, 16:00 GMT - A woman is more vulnerable to
sudden, serious heart disease during the time of the menstrual cycle when
her oestrogen levels are at their lowest, say researchers.

Levels of a form of oestrogen known as 17-oestradiol which circulates in
the bloodstream are known to dip sharply around menstruation.

A team from Laval University in Quebec, Canada, found that this time
coincided with a rise in reported cases of serious heart disease among
pre-menopausal women.

[Smoking] They studied 28 pre-menopausal white women in the Quebec area,
ages 35-47, who were admitted to the hospital for heart attack or serious
chest pain.

The women filled out a detailed questionnaire about their disease and
medication history, symptoms, hormonal status and risk factors such as
family history of heart disease, diabetes, high blood pressure, high
cholesterol and smoking.

Twenty of the women reported heart-related problems within five days of the
beginning of their period when oestrogen levels are at their lowest.

Lead researcher Dr Bettina Hamelin said: "We found that significantly more
pre-menopausal women experienced their heart attacks during or after their
periods when their natural oestrogen levels are low.

"However, these young women also had a number of other important risk
factors such as smoking and diabetes."

The link between oestrogen levels and heart disease was first established
by a US study in the late 1970s.

Researchers examined the residents of a town called Framingham in
Massachusetts, US.

They found that the rate of heart attacks in women increased significantly
after the age of 55.

This is the normal time of the menopause when oestrogen levels fall off
significantly.

It is thought that high levels of oestrogen circulating in a women's
bloodstream help to protect the heart.

The Quebec study will continue until at least 50 pre-menopausal women with
heart attacks and known menstrual-cycle history have been recruited.

Dr Hamelin said more data is needed to confirm that there is a vulnerable
time during the menstrual cycle which may constitute a trigger in women at
risk for heart disease.

A spokeswoman for the British Heart Foundation said the study raised
interesting questions about the effect of the sex hormones on the heart.

She said: "We understand that oestrogen may have a protective effect on the
heart in pre-menopausal women so it does seem logical that when hormone
levels are low, this protection may diminish temporarily.

"However, this study is not large or controlled enough to make any firm
conclusions.

"Whether this hypothesis is true or not, it still has to be established
conclusively so further research is important.

"The well known risk factors of smoking, raised blood pressure and high
cholesterol levels need to be highlighted over other less conclusive risks."

A study published in July by a team at St Thomas' Hospital, London, found
that young women with heart disease suffer worse symptoms at particular
times during their monthly menstrual cycle.

They found that the women were most likely to suffer angina - a chest pain
associated with heart disease - during or within a week of their period.

The Quebec research was presented at a conference of the American Heart
Association.


Related to this story:
Middle age 'too late' to get healthy (13 Nov 00 | Health)
HRT study signs up one million women (16 Oct 00 | Health)
Heart symptoms related to menstruation (26 Jul 00 | Health)
HRT 'reduces heart disease risk' (17 Apr 00 | Health)

Internet links:
American Heart Association
British Heart Foundation

BBC News Online: Health
http://news.bbc.co.uk/low/english/health/newsid_1022000/1022839.stm

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