Early menarche was found to be associated with poorer cardiovascular health (CVH), according to the results of a long-term national health survey published in Menopause: The Journal of The North American Menopause Society.

Data on demographics, CVH metrics, and age at menarche from 20,447 women collected during the 1999 to 2016 National Health and Nutrition Examinations Survey were examined.

A total of 11.2% of responders were considered to have ideal CVH. Women with vs without ideal CVH were younger (ie, <25 years; 24.2% vs 8.0%, respectively), had higher level of education (ie, college or above; 46.3% vs 21.8%, respectively), higher poverty to income ratio (ie, ³2; 69.7% vs 56.6%, respectively), were less likely to be non-Hispanic Black (7.0% vs 12.6%, respectively), or previously married (8.4% vs 26.7%, respectively).

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The average CVH score was lower among women who had early vs late menarche (7.89; 95% CI, 7.83-7.94 vs 8.40; 95% CI, 8.35-8.45, respectively).

The likelihood of having ideal CVH was lower among women who had early vs late menarche (odds ratio [OR], 0.70; 95% CI, 0.60-0.82; b, -0.40; 95% CI, -0.55 to -0.25). Women with late vs early menarche had increased odds of having ideal CVH (OR, 1.40; 95% CI, 1.21-1.62; b, 0.27; 95% CI, 0.13-0.42). The odds of ideal CVH increased by 17% with every additional year of age at menarche (OR, 1.17; 95% CI, 1.21-1.62).

Age at menarche and CVH were associated with smoking (OR, 1.04; 95% CI, 1.00-1.09) and body mass index (OR, 1.19; 95% CI, 1.15-1.23).

Late menarche and ideal CVH were associated with in women ages 25 to 30 years (OR, 1.63; 95% CI, 1.26-2.10) and in those ages 35 to 44 years (OR, 1.74; 95% CI, 1.31-2.30). Early menarche and ideal CVH were associated in women ages 25 to 34 years (OR, 0.72; 95% CI, 0.53-0.97).

Study limitations include its retrospective and self-reporting nature. It is likely some respondents may not have correctly recalled their exact age at menarche.

“Age at menarche may play an important role in maintaining and improving CVH, especially among young women,” concluded the study authors.


Zheng Y, Wen T S, Shen Y, et al. Age at menarche and cardiovascular health: results from the NHANES 1999-2016. [published online September 7, 2020] Menopause. doi:10.1097/GME.0000000000001653