According to a new study published in the Endocrine Society’s Journal of Clinical Endocrinology and Metabolism, women with long or irregular periods are not only more likely to develop type 2 diabetes and heart disease, but they may also be at risk for NAFLD.
What Constitutes as an Irregular Period?
Long or irregular menstrual cycles have long been associated with health conditions like polycystic ovary syndrome (PCOS), endometriosis, and pelvic inflammatory disease (PID). However, a group of researchers has recently discovered a link between irregular periods and liver disease. While it may seem like an oddity, liver diseases and period changes may be more closely related than you think. In this article, we’ll examine the link between irregular periods and liver disease, and what this new study has uncovered.
What constitutes an “irregular” period is different for everyone, which can make it difficult to determine whether or not you may have one. That said, the best way to determine whether or not your period is irregular is to listen to your body.
Put simply, an irregular period is defined as having a menstrual cycle that is constantly changing in length. This means that the gap between your periods either increases or decreases. The average menstrual cycle lasts 28 days, although it’s normal for it to be a bit shorter or longer than this.
Several factors can cause a long or irregular menstrual cycle. Sometimes, an abnormal cycle may be normal for you, while for others it can be irregular. Some common causes include:
- Puberty, your periods might be irregular for the first couple of years
- Early pregnancy
- Extreme weight loss or weight gain
- Medical conditions like PCOS
You don’t need to get medical advice if you have always had slightly irregular periods or you’re still going through puberty. That said, if your periods suddenly become irregular, especially for those under the age of 45, you should contact your general practitioner to rule out potential causes.
In the context of the study, long or irregular cycles were defined as menstrual cycles of 40 days or longer or too irregular to estimate.
What Is Nonalcoholic Fatty Liver Disease?
Nonalcoholic fatty liver, more commonly known as NAFLD, is a chronic disease in which excess fat builds up in your liver. It’s estimated that around 24% of adults in the United States have NAFLD, making it the most common form of chronic liver disease.
As the name suggests, NAFLD affects people who drink little to no alcohol. However, experts are unsure as to what causes some people to accumulate fat in the liver while others do not. Similarly, there is limited understanding of why some fatty livers develop inflammation that progresses to cirrhosis.
Some individuals with NAFLD can develop nonalcoholic steatohepatitis (NASH), an aggressive form of fatty liver disease, which is marked by liver inflammation and may progress to advanced scarring (cirrhosis) and liver failure. This damage is similar to the damage caused by heavy alcohol use.
Absent any type of drug approved by the Food and Drug Administration (FDA), the gold standard of care is a healthy diet and regular exercise. Scientists have understood for some time now that individuals with long or irregular periods are at an increased risk for developing type 2 diabetes and cardiovascular disease. However, a group of researchers from the Endocrine Society has recently discovered that they may also be at risk for NAFLD, without the presence of type 2 diabetes or obesity.
The Link Between Irregular Periods and Liver Disease
“Our study results show that long or irregular menstrual cycles may be associated with an increased risk of developing NAFLD, and this link was not explained by obesity,” said Seungho Ryu, M.D., Ph.D., of the Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine in Seoul, South Korea. “Previous studies have shown that long or irregular menstrual cycles are associated with type 2 diabetes and cardiovascular disease, but our study is the first to find a link between long or irregular menstrual cycles and NAFLD.”
Ryu and his colleagues analyzed data from the Kangbuk Samsung Health Study that consisted of 72,092 premenopausal individuals under the age of 40. These individuals underwent an annual or biennial health exam at health care centers in either Seoul or Suwon, South Korea. Of the 72,092 participants, 51,118 had no history of NAFLD at the time the study began.
The study lasted from 2011 to 2017, with one follow-up appointment conducted by December 31, 2019. The participants self-reported their menstrual cycle length, and lengths were categorized into six ranges: less than 21 days, 21 to 25 days, 26 to 30 days, 31 to 39 days, 40 days or more, or too irregular to estimate.
About 28% of these individuals had long or irregular menstrual cycles, and 7% had NAFLD. The researchers followed up four years later and found new cases of NAFLD had occurred in almost 9% of the women. The researchers concluded that there was an association between long or irregular menstrual cycles in young, premenopausal women and an increased risk of NAFLD.
Symptoms of NAFLD and Other Liver Diseases
NAFLD is sometimes referred to as a “silent liver disease” because it can happen without causing any noticeable symptoms. Most people with NAFLD can live a normal life without developing liver damage. In some instances, symptoms can occur, the most common of which include fatigue or pain in the upper right abdomen.
Where symptoms do arise, for the most part, is when NAFLD becomes NASH. If you have NASH, it could take years for your symptoms to develop. If liver damage from NASH goes untreated, it can cause cirrhosis.
Symptoms of NASH include:
- Severe tiredness
- Weight loss
- Yellowing of the skin or eyes
- Spiderlike blood vessels on the skin
- Long-lasting itching
“The association between long or irregular cycles and risk of developing NAFLD was independent of obesity and consistently observed in women without polycystic ovary syndrome, which means that women with long or irregular menstrual cycles should be encouraged to engage in healthy lifestyle behaviors regardless of obesity status or PCOS,” Ryu said.
“Young, premenopausal women with long or irregular menstrual cycles should be aware of future risk of developing nonalcoholic fatty liver disease and advised to engage in healthy lifestyle behaviors such as regular physical activity and healthy dietary habits to reduce risk of developing nonalcoholic fatty liver disease and other metabolic diseases.”
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