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Premenstrual symptoms linked to increased risk of cardiovascular disease
Last reviewed: 15.07.2025
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Women diagnosed with premenstrual symptoms have a slightly increased risk of developing cardiovascular disease later in life, according to a new study from the Karolinska Institutet published in the journal Nature Cardiovascular Research.
Premenstrual symptoms include premenstrual syndrome (PMS) and its more severe form, premenstrual dysphoric disorder (PMDD). These symptoms, which appear a few days before menstruation and then disappear, can be both psychological and physical.
The study included more than 99,000 women with premenstrual symptoms who were followed for up to 22 years. The researchers compared their health with women without such symptoms - both in the general population and with their siblings, to account for the influence of heredity and upbringing.
The results showed that women with premenstrual symptoms had about a 10% higher risk of developing cardiovascular disease. When different types of cardiovascular disease were examined, the association was particularly strong for abnormal heart rhythms (arrhythmias), where the risk was 31% higher, and for stroke caused by blood clots, where the risk was 27%.
Even after the researchers accounted for factors such as smoking, body mass index (BMI) and mental health, the link between premenstrual symptoms and increased disease risk remained.
"The increased risk was particularly noticeable in women who were diagnosed before age 25 and in those who had previously experienced postpartum depression, a condition that can also be caused by hormonal fluctuations," says Yihui Yang, a PhD student at the Institute of Environmental Medicine at Karolinska Institutet and first author of the study.
The reason for this connection has not yet been established, but the study authors suggest three possible explanations.
The first is that women with premenstrual symptoms may have dysregulation of the renin-angiotensin-aldosterone system (RAAS), which controls blood pressure and water-salt balance in the body.
Second, these women may have higher levels of inflammation in the body, which is a known risk factor for atherosclerosis and other heart diseases.
Finally, it is possible that women with premenstrual symptoms have metabolic disturbances associated with an increased risk of both stroke and heart attack.
"We hope our findings will help raise awareness that premenstrual disorders not only affect daily life but can also have long-term health consequences," says Donghao Lu, an assistant professor in the same department and the study's final author.