Problem suffered by many women linked to heart attack and stroke risk

Millions of women who suffer a severe form of premenstrual syndrome (PMS) are at far greater risk of suffering a potentially deadly stroke, a major study suggests.

While most women will suffer from PMS—which can cause distressing physical and emotional symptoms in the weeks before their period—at some point, about a third can suffer a severe form that can require treatment. 

Now, Swedish researchers have found women diagnosed with PMS were overall 10 per cent more likely to suffer from cardiovascular disease than women without a diagnosis. 

Breaking down cardiovascular disease by specific health problems, the team found these women had at 27 per cent greater risk of suffering a stroke and 31 per cent of developing a heart arrhythmia.

An arrhythmia is potentially serious problem with how the heart beats—either too slow, too fast or inconsistently—which can contribute to heart attacks. 

In the study, experts from the Karolinska Institute in Stockholm examined 22 years of health data from just under 100,000 women who had been diagnosed with PMS.

They compared heart health outcomes like stroke and arrhythmia diagnoses with rates in the general population as well as with the women’s sisters who hadn’t been diagnosed with PMS. 

Writing in the journal Nature Cardiovascular Research, the team said that even when accounting for factors known to increase cardiovascular disease risk—like obesity and smoking status—the link between health problems and PMS remained. 

Yihui Yang an expert in environmental medicine and first author of the study said the risk of these cardiovascular problems was particularly high for certain groups of women. 

‘The increased risk was particularly clear in women who were diagnosed before the age of 25 and in those who had also experienced postnatal depression, a condition that can also be caused by hormonal fluctuations,’ she said. 

Scientists said that exactly how PMS was causing an increased risk of cardiovascular problems was unclear.

They suggested that the heightened hormonal fluctuations PMS patients experience could disrupt other biological systems that control aspects like blood pressure, increase inflammation, or the conversion of food into energy, as potential factors.

However, the team added this was an area in need of further research. 

Estimates of how many women suffer from clinically significant—meaning requiring treatment—PMS vary as different criteria can be used. 

Some studies put the prevalence at one in 20 while others estimate it to be 30 per cent, roughly about one in three. 

Medics argue that if PMS causes issues that affect a woman’s physical, psychological, social and economic wellbeing than this warrants a diagnosis and subsequent support and treatment. 

However, British experts estimate that only between one in four and one in two women with clinically significant PMS actually seek help from doctors.  

PMS is an umbrella term for a range of physical and mental symptoms that typically occur one to two weeks before a woman’s period.

This is what is called the luteal phase of a woman’s menstrual cycle and is the period between ovulation—when an egg is released from an ovary—and menstruation—the shedding of the lining of the uterus that causes vaginal bleeding.  

Symptoms of PMS include mood swings, depression, irritability, anxiety, sleep problems, bloating and cramping, headaches, breast tenderness, spots, greasy hair and changes in appetite.

Some women experience more of these symptoms than others and the amount and severity of these can change over a course of a woman’s life. 

Women whose PMS is causing them issues are initially advised by the NHS to take steps like exercising more, doing yoga and meditation and cutting down on smoking and alcohol to help alleviate their symptoms.  

If these lifestyle changes don’t work women can contact their GP who can advise on further treatment. 

This can include cognitive behavioural therapy, hormone-based medications like the contraceptive pill, or antidepressants. 

More rarely, women can experience an extremely severe form of PMS known as premenstrual dysphoric disorder (PMDD).

PMDD patients can suffer an extreme physical and mental health problems that can include full-blown psychotic episodes and suicidal feelings. 

The condition is thought to affect about 824,000 women in the UK and 4.2 million in the US. 

The new study comes as heart attacks and strokes, particularly among young people, are on the rise in the UK.

Experts have blamed factors like factors like rising obesity levels as well as smoking and alcohol consumption for the rise in cardiac emergencies in the young. 

There is also some evidence that strokes are on the rise in younger people – with a quarter of strokes in the UK, around 20,000 cases, occurring in people of working age, according to the Stroke Association.

And while stroke cases diagnosed yearly has dropped in older age groups over the last 10 to 20 years, it has doubled in those under 55, according University of Oxford researchers who have a study to try to understand the reasons behind this rise.

Strokes are occur when the blood supply to the brain is cut off, usually by a blood clot in a critical artery. 

The medical emergency affects more than 100,000 Britons annually—one every five minutes—claiming 38,000 lives. 

Britons are advised to keep in mind the four-letter acronym, FAST (Face, arms, speech, time) for potential stroke symptoms.