Do female hormones have an effect on cardiac symptoms? And if so, what exactly is this influence? The answers to these questions are still unknown. And that’s why the Erasmus Medical Centre in Rotterdam (Holland) has set up The Cycle Study. Led by vascular internist Dr. Jeanine Roeters van Lennep, this research aims to improve the diagnosis and treatment of cardiovascular disease in women.
During the menstrual cycle, female hormones fluctuations occur. The link between the cycle and conditions such as migraine is well-known. But although it’s acknowledged that cardiac symptoms can be cyclic and many women have experienced this for themselves, the prevalence of menstrual cycle-related cardiac symptoms remains unclear. Same goes for implications for diagnosis and treatment.
The Cycle Study will be the first study to quantify the prevalence of menstrual cycle-related cardiac symptoms in pre-menopausal women. Eventually, researchers will be able to report whether these cyclic symptoms can be verified with objective diagnostic abnormalities. This knowledge can help both patients and their doctors. It can guide cardiologists to improve diagnosis and treatment of symptoms, by for example using prophylactic medication during the menstrual period or with continuous hormonal strategies to avoid hormonal fluctuations.
Female hormones have a lot to answer for
Women are eligible to participate in The Cycle Study if they have a regular menstrual cycle and suffer from cardiac complaints such as palpitations or chest pain. Five hundred of them will be asked to keep an electronic diary (via an app on their phone) for at least ten weeks. In this diary, they’ll record episodes of cardiac symptoms, including the nature of their symptoms, triggering factors, and menstrual cycle. In the second part of the study, forty women with a diagnosed relation between cardiac symptoms and their menstrual cycle will be further tested during in-depth studies at the Erasmus Medical Centre. The Cycle Study is financed by crowdfunding and special support of the Dutch Heart Foundation (NHF).
Migraines, PMS, menopausal problems and cardiac symptoms. Female hormones have a lot to answer for. Logical, as these hormones influence many things in our body. They affect the vessel wall, and also women’s blood pressure and cholesterol vary during the menstrual cycle. It’s unsurprising then that in women, apart from the normal risk factors such as cholesterol, hypertension and diabetes, female hormones also play a role in cardiovascular disease.
The majority of medical research has been done on men
The strange thing is that these effects have hardly been researched. The absolute majority of medical research has been done on men. It’s thought that women only make up one third of cardiovascular clinical trial subjects around the world. And even if female participants are included, sex is often neglected as results aren’t always reported by gender. Yet, women and men are genetically different from each other. This has an impact on everything from how our body operates, to how it reacts on medication. Heart attack symptoms, for example, also differ: men mainly experience chest pain, while women’s tell-tale signs also include less obvious symptoms, such as fatigue, nausea, indigestion, shortness of breath and palpitations.
‘By demonstrating the influence of female hormones, eventually lives can be saved’
Finding out more about these gender differences, in this case the influence of the menstrual cycle on cardiac complaints, can directly improve healthcare for women. And that’s of utmost importance as cardiovascular disease is the main cause of death in women. The fact that the effect of female hormones on cardiac symptoms is still so scarcely investigated, leads to unnecessary health risks. That’s also the opinion of vascular internist Dr. Roeters van Lennep, who’ll be leading The Cycle Study: ‘By demonstrating the influence of female hormones, I’m convinced that eventually lives can be saved.’
For more information about this important research, check out womensheartstudy.nl.
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