Trajectories of menstrual symptoms and blood pressure in midlife: A prospective cohort study on Australian women

AimTo investigate the associations between the trajectories of menstrual symptoms over 18 years and blood pressure in midlife using longitudinal data. MethodsUsing data from the Menarche-to-PreMenopause (M-PreM) study, sampled from the Australian Longitudinal Study on Womens Health, 494 participants were followed from their early 20s to mid-40s. Distinct trajectories of heavy menstrual bleeding, irregular periods, and severe period pain were identified by group-based trajectory modelling. The associations between menstrual symptom trajectories and blood pressure were examined by linear regression models. ResultsWe identified three distinct heavy menstrual bleeding trajectories and two for irregular periods and severe period pain. After accounting for blood pressure monitors and socio-demographic factors, women in the chronic heavy menstrual bleeding group and late onset heavy menstrual bleeding group exhibited higher systolic (SBP) and diastolic (DBP) blood pressure compared to the normative group. The late onset irregular periods group also had higher DBP than the normative group. When we further adjusted for lifestyle factors, body mass index, and waist-to-hip ratio, the associations were attenuated (chronic heavy bleeding: SBP [B=3.0; 95% CI: -1.1, 7.0] and DBP [B=2.5; 95% CI: -0.3, 5.2]; late onset heavy menstrual bleeding: SBP [B=3.4; 95% CI: 0.3, 6.5] and DBP [B=3.1; 95% CI: 1.0, 5.2]). We found no associations between severe period pain and blood pressure. ConclusionsThe trajectories of heavy menstrual bleeding and irregular periods during the reproductive span were associated with blood pressure in midlife. This suggests that tracking menstrual symptoms in women could help predict their midlife blood pressure.