Longer Menstrual Cycles, Contraceptive Use Linked to Higher Risk of Type 2 Diabetes

Longer menstrual cycles and contraceptive use are linked to a higher risk of developing type 2 diabetes (T2D), while later puberty and later menopause are associated with lower T2D risk, according to research presented at the 55th Annual Meeting of the European Association for the Study of Diabetes (EASD).

Results for the study were presented at the EASD Annual Meeting in Barcelona, Spain, which opened September 16 and runs through September 20.

As early screening and subsequent treatment for metabolic disorders could lower the risk of further complications, researchers sought to evaluate the association of female hormonal life course to the risk of incident T2D in a large prospective female E3N cohort study.

The study, set to be published in the journal Diabetologia, examined data collected on 83,799 French women from 1992 to 2014. Hormonal factors such as age at puberty, age at menopause, breastfeeding, total menstrual cycles, contraceptive use, and time between menstruation were measured in relation to incident T2D risk through computer models that determined statistical significance. These computer models were adjusted for the main T2D risk factors: body mass index, smoking, age, physical activity, socioeconomic status, education level, family history of T2D, and blood pressure.

Data revealed significant reductions for incident T2D risk in higher age at puberty of ≥14 years as opposed to <12 years (12% reduced risk; hazard ratio [HR] = 0.88; 95% CI, 0.81-0.95), increased age at menopause ≥52 years compared to <47 (30% reduced risk; HR = 0.70; 95% CI, 0.63-0.78), and breastfeeding compared with non-breastfeeding women (10% reduced risk; HR = 0.90; 95% CI, 0.85-0.95).

Increased total lifetime number of menstrual cycles, ≥471.78 as opposed to <391.34, was additionally found to reduce incident risk of T2D (25% reduced risk; HR = 0.75; 95% CI, 0.68-0.82), as did longer exposure to sex hormones, ≥38 years compared to <31.9 years, which measured the time between puberty and menopause (34% reduced risk; HR = 0.66; 95% CI, 0.61-0.73).

Contraceptive use, however, exhibited an increased incident risk of T2D for women who have used it at least once compared to never using women (33% increased risk; HR = 1.33; 95% CI, 1.25-1.42), along with longer menstrual cycle length, ≥32 days compared to ≤24 days, which measured the time between periods (23% increased risk; HR = 1.23; 95% CI, 1.07-1.41).

Significant risks of T2D through contraceptive use and menstrual cycle length exhibit indicative variables that can be used to determine risk for women. The authors described how women who fall into higher risk of T2D through predisposed conditions may need heightened knowledge when it comes to possible contraceptive use.

“Risk induced by oral contraceptives could lead to personalized advice for young women at risk of developing T2D, such as those with a family history of diabetes, those who are overweight or obese, or those with polycystic ovary syndrome,” wrote the authors.

Longer exposure to sex hormones was associated with a possible reduction in T2D risk for women later in life as shown by data on increased menstrual cycles and reduced menstrual cycle length. By measuring hormonal factors such as these, as well as, the age at puberty and menopause, physicians can determine the risk of T2D and correlating benefits of contraceptive use for women.

Reference

Tatulashvili S, Gusto G, Balkau B, et al. Hormonal factors and type 2 diabetes risk in women. Presented at the 55th Annual Meeting of the European Association for the Study of Diabetes, Barcelona, Spain; September 16-20, 2019; Abstract 552.