A large-scale UK study of over 500,000 adults reveals that starting menstruation before age 12 raises the risk of heart disease and stroke later in life. Other key reproductive factors—early menopause, pregnancy complications, and hysterectomy—also show strong associations with cardiovascular disease.
Researchers analyzed data from 526,000 men and women up to age 69, recruited between 2006 and 2010 with no prior cardiovascular disease. Participants were tracked until March 2016 or their first heart attack or stroke. Women averaged 56 years old at baseline; 51% were from the wealthiest UK socioeconomic group, and 60% had never smoked.
The average age at menarche was 13; 85% of women had been pregnant, 44% had two children, and first births occurred around age 26 on average. One in four reported a miscarriage, 3% a stillbirth, and two-thirds had reached menopause at age 50 on average. Among men, 42% had fathered two children.
Over about seven years, 9,054 cardiovascular events occurred—34% in women—including 5,782 coronary artery disease cases (28% women) and 3,489 strokes (43% women). Adjusting for confounders, early menarche (before 12) linked to 10% higher cardiovascular risk versus age 13+. Early menopause (before 47) tied to 33% greater cardiovascular risk (42% for stroke). Each miscarriage raised heart disease risk by 6%; stillbirth by 22% for cardiovascular disease and 44% for stroke. Hysterectomy increased cardiovascular risk by 12% (20% for heart disease), doubling with ovary removal. Later first parenthood lowered risk by 3% per year. Child number effects were similar across sexes, pointing to social, psychological, and behavioral influences over purely biological ones.
