Changes in the length of a woman’s menstrual cycle in the years just prior to menopause can offer clues to their risk of developing heart disease, a new study suggests.

The study, published in Menopause, found that women whose cycle  became longer in the two years before their final menstrual period had better measures of vascular health than those whose cycle length was unchanged.

“Menopause is not just a click of a button,” said lead author Samar El Khoudary, Ph.D., associate professor of epidemiology at the University of Pittsburgh’s Graduate School of Public Health. “It’s a multistage transition where women experience many changes that could put them at higher risk for cardiovascular disease.

“Change in cycle length, which is linked to hormone levels, is a simple metric that might tell us who is more at risk.”

El Khoudary’s team analyzed data for 428 women over 10 years starting between ages 45 and 52. About 62% had stable cycles that didn’t change before menopause. Those women, compared with those whose cycled lengthened, had better measures of artery hardness and thickness, suggesting a smaller risk of cardiovascular disease.

Hormone levels tied to heart health

The researchers suspect menstrual cycle length during menopause is a reflection of hormone levels, which contribute to heart health.

“Cardiovascular disease is the No. 1 killer of women, and the risk significantly increases after midlife, which is why we think that menopause could contribute to this disease,” El Khoudary said. “These findings are important because they show that we cannot treat women as one group: Women have different menstrual cycle trajectories over the menopause transition, and this trajectory seems to be a marker of vascular health.”

She also wants to research whether menstrual cycle patterns are linked to other risk factors for heart health, such as abdominal fat, which has been shown to be a factor in cardiovascular disease in menopause.