Cycle Abnormalities and Cardiometabolic Health

Cycle abnormalities are predominantly known to affect women’s reproductive health due to irregular or absent menstrual bleeding and anovulation. However, a women’s future cardiometabolic health may also be affected by ovarian dysfunction. The polycystic ovary syndrome (PCOS) constitutes the most common form of chronic ovulatory dysfunction in women of reproductive age. PCOS is often associated with hyperandrogenism, insulin resistance and cardiometabolic abnormalities, affecting women’s health during various life stages including peri- and postmenopause. Moreover, pregnancy complications and the health of offspring may be compromised. Ovulatory dysfunction due to premature menopause or the occurrence of hypothalamic amenorrhea in female athletes, is often associated with an extended hypoestrogenic state. Next to increased chances for osteoporosis and associated bone fractures, this prolonged state of hypoestrogenism impairs cardiometabolic health and is associated with an increase in cardiovascular disease and mortality. Furthermore premature menopause is associated with a decrease in circulating androgen concentrations, which may influence cognition, sexual health, general wellbeing along with cardiometabolic health. Thus, cardiometabolic health in women with cycle abnormalities is characterized by a complex interaction between hormonal changes, specific patient features such as age and BMI, underlying genetic traits and different environmental factors.