美国哈佛大学陈曾熙公共卫生学院Jorge E Chavarro团队研究了月经周期的规律性与过早死亡风险之间的关系。2020年9月30日，该研究发表在《英国医学杂志》上。

为了评估整个生命过程中月经周期不规律或较长是否与全因或特定原因的过早死亡（年龄<70岁）有关，研究组进行了一项前瞻性队列研究。共招募了79505名无心血管疾病、癌症或糖尿病病史的绝经前女性，她们报告了14-17岁、18-22岁和29-46岁的正常月经周期和长度。

在24年的随访中，共有1975例过早死亡，包括894例癌症和172例心血管疾病。总是月经周期不规律的女性，与相同年龄范围内周期规律的女性相比，随访期间的死亡率更高。

14-17岁时月经周期非常规律的女性和月经周期总是不规律的女性每1000人年随访的粗死亡率分别为1.05例和1.23例，18-22岁年龄段分别为1.00例和1.37例，29-46岁年龄段则分别为1.00例和1.68例。各年龄段过早死亡的相应多变量校正风险比分别为1.18、1.37和1.39。

18-22岁和29-46岁年龄段月经周期为40天及以上的女性，与相同年龄范围内周期为26-31天的正常女性相比，更容易过早死亡，风险比分别为1.34和1.40。在与心血管疾病有关的死亡中，这些相关性最为明显。在目前的吸烟者中，月经周期较长和不规律的女性死亡率更高。

总之，青春期和成年期月经周期不规律和较长与过早死亡（年龄<70岁）的高风险有关。

附：英文原文

Title: Menstrual cycle regularity and length across the reproductive lifespan and risk of premature mortality: prospective cohort study

Author: Yi-Xin Wang, Mariel Arvizu, Janet W Rich-Edwards, Jennifer J Stuart, JoAnn E Manson, Stacey A Missmer, An Pan, Jorge E Chavarro

Issue&Volume: 2020/09/30

Abstract:

Objective To evaluate whether irregular or long menstrual cycles throughout the life course are associated with all cause and cause specific premature mortality (age <70 years).

Design Prospective cohort study.

Setting Nurses’ Health Study II (1993-2017).

Participants 79505 premenopausal women without a history of cardiovascular disease, cancer, or diabetes and who reported the usual length and regularity of their menstrual cycles at ages 14-17 years, 18-22 years, and 29-46 years.

Main outcome measures Hazard ratios and 95% confidence intervals for all cause and cause specific premature mortality (death before age 70 years) were estimated from multivariable Cox proportional hazards models.

Results During 24 years of follow-up, 1975 premature deaths were documented, including 894 from cancer and 172 from cardiovascular disease. Women who reported always having irregular menstrual cycles experienced higher mortality rates during follow-up than women who reported very regular cycles in the same age ranges. The crude mortality rate per 1000 person years of follow-up for women reporting very regular cycles and women reporting always irregular cycles were 1.05 and 1.23 for cycle characteristics at ages 14-17 years, 1.00 and 1.37 for cycle characteristics at ages 18-22 years, and 1.00 and 1.68 for cycle characteristics at ages 29-46 years. The corresponding multivariable adjusted hazard ratios for premature death during follow-up were 1.18 (95% confidence interval 1.02 to 1.37), 1.37 (1.09 to 1.73), and 1.39 (1.14 to 1.70), respectively. Similarly, women who reported that their usual cycle length was 40 days or more at ages 18-22 years and 29-46 years were more likely to die prematurely than women who reported a usual cycle length of 26-31 days in the same age ranges (1.34, 1.06 to 1.69; and 1.40, 1.17 to 1.68, respectively). These relations were strongest for deaths related to cardiovascular disease. The higher mortality associated with long and irregular menstrual cycles was slightly stronger among current smokers.

Conclusions Irregular and long menstrual cycles in adolescence and adulthood are associated with a greater risk of premature mortality (age <70 years). This relation is slightly stronger among women who smoke.

DOI: 10.1136/bmj.m3464

Source: https://www.bmj.com/content/371/bmj.m3464