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Editor's Correspondence |

Menstruation and Cardiovascular Vulnerability

Martin Terplan, MD
Arch Intern Med. 2005;165(1):120. doi:10.1001/archinte.165.1.120-b.
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In their commentary, Kannel and Levy1 thoroughly describe studies of the relationship between hormones, menopause, and CHD. They noted that CHD rises substantially after menopause, whether surgical or natural, and whether the ovaries were removed or not. What accounted for the low incidence of CHD before menopause remained unclear. They did not discuss whether menstrual blood loss could explain the finding.

I believe that menstrual blood loss alone could explain the protection against CHD in premenopausal women. Possible mechanisms include lowered blood viscosity, lowered blood pressure, lowered coagulopathy, or reduced body iron.

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