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Long or Irregular Menstrual Cycles May Predict Type 2 Diabetes

Women who have long or highly irregular menstrual cycles are at increased risk for type 2 diabetes mellitus.

"Oligomenorrhea at the age of 18 to 22 years was a significant predictor of subsequent development of type 2 diabetes mellitus in participants in the Nurses' Health Study II," United States researchers report.

"This observation was not explained simply by associated obesity or several other confounding variables."

They suggest the findings are consistent with "the suggestion of previous cross-sectional studies that menstrual cycle irregularities may be a marker for associated metabolic abnormalities."

Investigators say women with a history of long or irregular menstrual cycles might benefit particularly from lifestyle approaches to risk reduction, including weight control and exercise.

A total of 101,073 women enrolled in the prospective observational cohort Nurses" study. They had no prior history of diabetes. Participants reported on their usual menstrual cycle pattern at baseline in 1989, when they would have been from 18 to 22 years old.

Researchers from Brigham and Women's Hospital and Harvard University in Boston, Massachusetts point out that long or highly irregular menstrual cycles may be associated with insulin resistance.

"Women with polycystic ovary syndrome, a condition characterized by oligomenorrhea and androgen excess, have a high prevalence of glucose intolerance and type 2 diabetes that is not simply attributable to being overweight."

They followed participants in the Nurses' study through 1997. They analysed incident reports of diabetes among the women using five categories of menstrual cycle length.

Investigators report: "During 564,333 person years of follow-up, there were 507 cases of type 2 diabetes mellitus.

"Compared with women with a usual cycle length of 26 to 31 days at age 18 to 22 years, the relative risk of type 2 diabetes among women with a menstrual cycle length that was 40 days or more or was too irregular to estimate was 2.08."

They adjusted for body mass index at age 18 years and several other confounding variables: age, family history of diabetes in first-degree relatives, smoking, weight change and use of oral contraceptives.

Researchers also found that the relative risk of type 2 diabetes associated with long or highly irregular cycles was greater in obese women, "but was also increased in non-obese women."
JAMA, 2001; 286: 2421-2426. "Long or Highly Irregular Menstrual Cycles as a Marker for Risk of Type 2 Diabetes Mellitus"

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