Hypothalamic amenorrhea in mid-adulthood linked to heart disease

In a prospective study of 52,655 premenopausal women from the Nurses' Health Study II, researchers assessed whether a functional hypothalamic amenorrhea (FHA) phenotype was linked to incident cardiovascular disease. Participants were free of cardiovascular disease in 1993 and followed biennially through 2019, recording 1,007 cardiovascular events over up to 26 years. The FHA phenotype was defined as irregular or absent cycles without polycystic ovary syndrome traits, paired with low body mass index or high physical activity. Compared with regular cycles, FHA in mid-adulthood was associated with a 62% higher risk of cardiovascular disease and a higher risk of coronary heart disease (HR = 1.91). FHA was also linked to type 2 diabetes (HR = 1.86), but not hypertension or elevated cholesterol. FHA in early adulthood was not associated with outcomes.