When we think about cardiovascular health, we often jump to cholesterol levels, exercise, or family history. Rarely do we consider our menstrual cycles as part of the heart health equation, but we should. Emerging research is making it increasingly clear that what happens in the uterus doesn’t stay there. In fact, menstrual patterns may offer valuable insight into the state of your vascular system.

Heavy menstrual bleeding (HMB), often brushed off as just an inconvenience or a “normal” part of aging, can actually be a signal of underlying cardiovascular risk, particularly high blood pressure (hypertension). Understanding this connection may not only improve your menstrual health, but could be key in preventing heart disease later in life.

The Overlap Between Heavy Periods and Hypertension

Recent findings have revealed that women with hypertension are more likely to experience heavy menstrual bleeding. Why? It turns out that both conditions share common biological pathways and risk factors, many of which are often under-recognized in women’s health.

Here’s what the research tells us:

• Shared risk factors such as obesity, insulin resistance, and chronic inflammation are common in both heavy menstrual bleeding and hypertension.
• Vascular dysfunction plays a role in both conditions. When blood vessels aren’t functioning optimally, it affects not only blood pressure regulation but also the vascular integrity of the uterus, which can lead to heavier bleeding.
• Hormonal imbalances, particularly those involving estrogen and progesterone, influence both menstrual regulation and blood pressure control. Estrogen has a vasodilatory effect (helps blood vessels relax), and when it's disrupted, it can contribute to both HMB and increased cardiovascular strain.

This link is particularly significant for women in their 30s and 40s—the age range where many start to notice cycle changes and where early signs of hypertension may first appear.

What Heavy Bleeding Can Tell You About Your Heart

Heavy menstrual bleeding isn’t just a quality-of-life issue—it may be an early clinical indicator of underlying vascular dysfunction. In a large study published in BMC Medicine, researchers found that women with heavy menstrual bleeding were significantly more likely to have hypertension, even after adjusting for other health conditions. This reinforces the idea that menstrual irregularities may be early warning signs for long-term cardiovascular risk.

While this doesn’t mean every heavy period is a red flag, it’s important to pay attention to your cycle, especially if symptoms are new, worsening, or paired with other risk factors like:

• High blood pressure readings
• Family history of cardiovascular disease
• Weight gain, particularly around the abdomen
• Fatigue or shortness of breath during routine activities

Proactive Steps You Can Take

If you’re dealing with heavy menstrual bleeding, it’s worth having a deeper conversation with your healthcare provider, not just about symptom relief, but about your overall vascular health. Here are some practical steps to consider:

• Track your cycle regularly with the Obie app to monitor changes in flow, frequency, and pain
• Ask your provider to evaluate your blood pressure and metabolic health
• Discuss screening for conditions like PCOS, fibroids, or clotting disorders
• Incorporate heart-healthy lifestyle changes such as:
• Prioritizing whole foods and reducing sodium
• Engaging in regular aerobic exercise (e.g., walking, swimming, cycling)
• Managing stress through mindfulness, yoga, or therapy
• Limiting alcohol and quitting smoking, if applicable

A New Perspective on Women’s Health

It’s time to expand our understanding of menstrual health. Your cycle is more than a reproductive tool—it’s a vital sign. Recognizing heavy bleeding as a potential marker of vascular health can help women take proactive steps before cardiovascular issues develop.

With heart disease being the leading cause of death for women worldwide, listening to what your cycle is telling you isn’t just smart—it’s lifesaving.

Source:
 Vila, M., Bergman, E., & Berntorp, E. (2024). Heavy menstrual bleeding is associated with increased prevalence of hypertension in women: a nationwide cross-sectional study. BMC Medicine, 22(1), 88. https://bmcmedicine.biomedcentral.com/counter/pdf/10.1186/s12916-024-03426-8.pdf