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

• Published in: Case reports in women's health Vol. 37; p. e00486
• Main Authors: van der Bijl, Marte F, Sunamura, Madoka, Ter Hoeve, Nienke, Schreuder, Michelle M, Lenzen, Mattie J, Roeters van Lennep, Jeanine E
• Format: Report
• Language: English
• Published: 01.03.2023
• ISSN: 2214-9112
• DOI: 10.1016/j.crwh.2023.e00486

BackgroundThe 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. MethodsAll 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. ResultsOf 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. ConclusionsThe 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.