Share on PinterestIssues related to female reproductive health may increase the risk of metabolic conditions later in life. Image credit: Maryna Terletska/Getty Images. Metabolic health refers to a person’s blood glucose, lipids, blood pressure, and body fat levels, which may be influenced by lifestyle choices. Additionally, life events can also impact the risk of developing chronic metabolic conditions such as type 2 diabetes and high cholesterol.According to a recent review, certain reproductive milestones in females, including early puberty, excessive weight gain during pregnancy, and severe menopause symptoms, are associated with adverse metabolic health. The review suggests that healthcare providers should consider gender-specific risk factors when evaluating a person’s metabolic health. Metabolic syndrome, a cluster of conditions that increase the risk of coronary heart disease, type 2 diabetes, stroke, and other health issues, poses a risk for individuals who are not metabolically healthy. In the United States, approximately one in three adults have metabolic syndrome. In order to maintain metabolic health and reduce the risk of heart disease as well as the likelihood of developing type 2 diabetes, the National Heart, Lung, and Blood Institute recommends the following:
Choosing heart-healthy foods, such as fruits, vegetables, and whole grains, while limiting saturated fat, added salt, sugars, and alcohol intake
Striving for a healthy weight
Engaging in regular physical activity
Managing stress and getting enough sleep
Quitting smoking
A new review of existing evidence suggests that for women, their reproductive milestones may have a negative impact on their risk of metabolic dysfunction, potentially leading to type 2 diabetes and high cholesterol. The researchers of the review propose that screening for reproductive risk factors, such as early onset of menstruation, polycystic ovary syndrome (PCOS), weight gain during pregnancy, and severity of menopause symptoms, could be a crucial step in preventing or treating these metabolic diseases.Their findings were published in Cell Metabolism. The researchers explored the evidence linking the traits of reproductive milestones with metabolic health and disease, finding that various reproductive factors throughout a woman’s lifetime were associated with metabolic health. These factors included:
Early menarche – beginning menstruation before the age of 12 was linked to abnormal blood glucose levels, high cholesterol, metabolic syndrome, and type 2 diabetes
Irregular menstruation – chronic irregular menstruation was associated with a higher risk of developing type 2 diabetes compared to regular menstruation
PCOS – a strong relationship between PCOS, obesity, and type 2 diabetes was identified
Pregnancy – gestational diabetes, excessive weight gain during pregnancy, and gestational lipid levels were all connected to poorer metabolic health later in life
Lactation – longer lactation was linked to better metabolic health and a lower risk of type 2 diabetes and metabolic syndrome
Menopause – severe menopause symptoms and early menopause were linked to a higher risk of type 2 diabetes, although evidence suggested that postmenopausal estrogen therapy could reduce this risk. While this study does not investigate the causes of these associations, most of these risk factors are connected to increased insulin resistance, which affects metabolic health. According to Dr. G. Thomas Ruiz, a board-certified OB/GYN and lead OB/GYN at MemorialCare Orange Coast Medical Center in Fountain Valley, CA, these risk factors are associated with insulin insensitivity, which can lead to obesity and adult-onset diabetes.According to the researchers, the majority of shared risk factors can be categorized as genetics, hormonal fluctuations and resulting physiology, or adiposity. Adiposity, or excess body fat, is associated with metabolic syndrome and many reproductive factors examined in the study. Dr. Amy R. Nichols, Research Fellow at the Harvard Pilgrim Health Care Institute and the Harvard T.H. Chan School of Public Health and the lead author of the study, stated that although there is compelling evidence of a link between reproductive risk factors and metabolic disease, the relationship between these adverse reproductive outcomes and metabolic health later in life is not entirely explained by traditional risk factors such as excess adiposity, diet, or physical inactivity. The researchers do not claim that traits of reproductive milestones cause metabolic disorders, but they emphasize the existence of links and suggest the presence of other underlying factors connecting them. Although they cannot demonstrate a causal relationship, acknowledging that these reproductive milestones may be risk factors is a step toward a better understanding of the development of metabolic dysfunction. The authors underscore the need for further research to comprehend these complex relationships. Dr. Nichols stated that “reproductive milestones should be considered risk factors for poorer metabolic health in later life” and added that proactive measures, including lifestyle factors like diet, physical activity, and medication management, could potentially mitigate the adverse outcomes associated with adverse reproductive characteristics. She suggested that clinicians should consider these sex-specific risk factors for metabolic disorders and evaluate patients for the history or presence of known reproductive risk factors, in addition to assessing traditional risk factors such as smoking, diet, and physical activity. The acknowledgment of these reproductive risk factors may lead to better long-term outcomes for patients. Despite reproductive risk factors, individuals can minimize their risk and reduce the likelihood of developing conditions such as type 2 diabetes and high cholesterol in later life by following a healthy diet and lifestyle.
