Effects of menstruation on the onset of acute coronary syndrome in premenopausal women: A case series

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Abstract

Background: The incidence of cardiovascular disease (CVD) among women is lower before the menopause, which may be due to the atheroprotective effects of female sex hormones, including estrogens. This study explored whether women experienced acute coronary syndrome (ACS) more often during menstruation, when the levels of female sex hormones are low. Methods: All premenopausal women referred to the local cardiac rehabilitation program after ACS between August 2010 and September 2018 were contacted by telephone to gather information about their menstrual cycle, contraceptive use and whether ACS occurred during menstruation. Information on cardiovascular risk factors was collected using the clinical electronic health record. Results: Of the 22 women fulfilling the inclusion criteria and having a regular menstrual cycle, 22.7% reported that they were diagnosed with ACS at the time of menstruation. Conclusions: The percentage of women who were menstruating whilst having their cardiovascular event is higher than the percentage expected if the event was unrelated to the menstrual cycle. To gain more insight into the effect of female sex hormones on ACS, it is suggested that information on the menstrual cycle is routinely collected from women admitted to hospital with the condition.

Original languageEnglish
Article numbere00486
JournalCase Reports in Women's Health
Volume37
DOIs
Publication statusPublished - Mar 2023

Bibliographical note

Funding Information:
Marte F. van der Bijl contributed to conception and development of the study, acquisition of data, and manuscript writing and editing. Madoka Sunamura contributed to conception and development of the study, reviewing drafts of the manuscript, and patient care at the Capri CR;, Nienke ter Hoeve contributed to conception and development of the study, and reviewing drafts of the manuscript. Michelle M. Schreuder contributed to conception and development of the study, and reviewing drafts of the manuscript;, Mattie J. Lenzen contributed to interpretation of data and reviewing drafts of the manuscript. Jeanine E. Roeters van Lennep contributed to conception and development of the study, reviewing drafts of the manuscript and manuscript editing. All authors read and approved the final version of the manuscript. All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation. No funding from an external source supported the publication of this article. Obtained. The research was conducted in accordance with the Declaration of Helsinki [10]. The Erasmus MC Medical Ethics Committee decided that according to the Dutch Human Research Law (WMO), the protocol required no formal ethical approval. All patients provided written informed consent. Peer review was directed by Professor Margaret Rees, Editor-in-Chief, independently of Jeanine Roeters van Lennep, one of the authors and a member of the editorial board of Case Reports in Women's Health, who was blinded to the process.

Publisher Copyright:
© 2023 The Authors

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