How Reproductive Factors Can Affect a Woman’s Heart Health

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  • New research shows a link between earlier first birth, a higher number of live births, and starting periods at a younger age with a greater risk of atrial fibrillation, coronary artery disease, heart failure, and stroke in women.
  • While there are traditional cardiovascular risk factors to be aware of (high cholesterol, high blood pressure, obesity, etc.) there are female-specific risk factors to take into consideration such as problems during pregnancy and hormonal changes that occur during menopause.
  • It’s important for women to be aware of risk factors, including traditional and reproductive, so they can take the necessary steps to lower their risk of developing heart problems.

Over 60 million women in the United States are living with some type of heart condition. The reasons for cardiovascular issues range from high cholesterol, high blood pressure and obesity to reproductive health.

According to a new study published this week in the Journal of the American Heart Association, earlier first birth, a higher number of live births, and starting periods at a younger age are all associated with an increased risk of heart problems in women.

Researchers specifically examined these reproductive factors and their connection to the following heart conditions: atrial fibrillation, coronary heart disease, heart failure, and stroke.

“While we cannot say exactly how much these factors increase the risk of cardiovascular disease, our study shows that reproductive history is important and it points towards a causal impact,” Dr. Fu Siong Ng, senior author for the study, from the National Heart and Lung Institute at Imperial College London said in a statement. “We need to understand more about these factors to make sure that women get the best possible care.”

Further research is required to learn more about the relationship between reproductive history and heart health.

Reproductive factors and cardiovascular disease

Cardiologists agree there is a strong link between reproductive health and cardiovascular health.

“These reproductive factors are associated with an increase in risk factors such as hypertension, hyperlipidemia, diabetes, and inflammation, all of which increase the risk of stroke, atrial fibrillation, heart attack and heart failure,” said Dr. John Higgins, a cardiologist with McGovern Medical School at UTHealth Houston.

For example, getting your period early or before age 12 is associated with adiposity and obesity, and metabolic syndrome. In fact, both early start to menstruation and late menopause (i.e. longer lifetime exposure to estrogen) have been associated with increased risks for coronary heart disease.

Additionally, having more live births is associated with higher BMI, increased blood pressure, and elevated blood glucose, total cholesterol and triglycerides, Dr. Higgins added.

The physiological changes women experience throughout their lives also play a major role in heart health.

“These reproductive factors, or a ‘more reproductive phenotype’, as the study describes them, are most likely associated with CVD risk because of the physiological changes that occur during pregnancy,” Dr. Supreeti Behuria, Director, Nuclear Cardiology at Staten Island University Hospital, told Healthline. “These physiological changes include hormonal changes and these ‘augment’ the ‘traditional’ risk factors for CVD, for example, high cholesterol, insulin resistance, and increased weight.”

These changes also cause the body to be in a more inflammatory state and increase blood clotting. During pregnancy, the body is exposed to these changes for 9 months, and with multiple pregnancies, the body is exposed to these changes multiple times, and this can increase CVD risk, Dr. Beheria added.

Additional risk factors

“The risks that affect women include the traditional risk factors, for example, high blood pressure, high cholesterol, diabetes, obesity, smoking, being sedentary, and not eating a heart-healthy diet,” said Dr. Behuria.

However, there are female-specific risk factors to be aware of.

These include starting one’s period very early or very late, and problems during pregnancy, for example gestational diabetes or high blood pressure during pregnancy and menopause. Menopause does not cause heart disease on its own but the hormonal changes that occur during menopause can increase the risk of heart disease, Dr. Behuria stated.

Other risk factors for women are having Polycystic Ovarian Syndrome or taking hormone replacement therapy. Some chemotherapy that is used for breast cancer treatment can also increase risk.

Dr. Higgins explained that women should be aware that certain risk factors increase their risk of cardiovascular disease including:

Preeclampsia, pregnancy-induced hypertension, gestational diabetes, premature menopause ( before 40 years of age), chronic inflammatory conditions such as psoriasis, rheumatoid arthritis (RA) and lupus which is linked to twice the risk of CAD.


According to a new study, there is a connection between women’s reproductive history and heart health.

Researchers found that earlier first birth, a higher number of live births, and starting periods at a younger age with a greater risk of atrial fibrillation, coronary artery disease, heart failure, and stroke in women, were linked to an increased risk of cardiovascular disease.

It’s crucial for women to be aware of both traditional cardiovascular risk factors (obesity, high blood pressure, high cholesterol) and female-specific risk factors to protect their overall health.

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