Neurology: The earlier the age of menopause and the shorter the reproductive lifespan (≤35 years), the higher the risk of aneurysmal subarachnoid hemorrhage (ASAH) in women!

Subarachnoid hemorrhage caused by ruptured cerebral aneurysm is a disease with high mortality and morbidity
.

Postmenopausal women have higher rates of aneurysmal subarachnoid hemorrhage (ASAH) and subsequent complications, including cerebral vasospasm, compared with premenopausal women

Subarachnoid hemorrhage caused by ruptured cerebral aneurysm is a disease with high mortality and morbidity

Although the reasons for the higher incidence of subarachnoid hemorrhage in postmenopausal women are unknown, a hormonal influence has been postulated in the pathogenesis of cerebral aneurysms and their rupture

Through a large prospective cohort study called the Nurses' Health Study (NHS) , researchers investigated the relationship between reproductive lifespan, age at menarche, age at menopause, and use of oral contraceptives or postmenopausal hormone therapy in women

Participants in the Nurses' Health Study (NHS) study were followed from 1980 or postmenopause to 2018, and only women who were naturally or postmenopausal after bilateral oophorectomy were included
.

Reproductive lifespan is defined as age at menarche minus age at menarche

Participants in the Nurses' Health Study (NHS) study were followed from 1980 or postmenopause to 2018, and only women who were naturally or postmenopausal after bilateral oophorectomy were included

• A total of 97,398 postmenopausal women with reproductive lifespan data were enrolled, as established by physician review visit records, of which 138 participants developed aneurysmal subarachnoid hemorrhage
  .
  
• After adjustment for multiple factors, the shorter the reproductive period (≤35 years), the incidence of ASAH increased by 2 times (HR=2.
  0 [95%CI 1.
  42.
  8])
  .
  
• Similarly, early age at menopause (45 ≤ years) was associated with a higher risk of ASAH (HR = 2.
  1 [95% confidence interval 1.
  4-3.
  1]), but age at menarche was not associated
  .
  
• Oral contraceptive use and postmenopausal hormone therapy were not associated with the incidence of ASAH
  .
  

A total of 97,398 postmenopausal women with reproductive lifespan data were enrolled, as established by physician review visit records, of which 138 participants developed aneurysmal subarachnoid hemorrhage
.

A total of 97,398 postmenopausal women with reproductive lifespan data were enrolled, as established by physician review visit records, of which 138 participants developed aneurysmal subarachnoid hemorrhage
.

After adjustment for multiple factors, the shorter the reproductive period (≤35 years), the incidence of ASAH increased by 2 times (HR=2.

The earlier the age of menopause and the shorter the reproductive lifespan (≤35 years), the higher the risk of ASAH in women

Source: Rosalind Lai PM, Jimenez M, Du R, Rexrode K.
Association of Reproductive Life Span and Age at Menopause With the Risk of Aneurysmal Subarachnoid Hemorrhage [published online ahead of print, 2022 Mar 29].
Neurology.
2022;10.
1212/ WNL.
0000000000200447.
doi:10.
1212/WNL.
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