Prior, J. C. (2014). Progesterone Within Ovulatory Menstrual Cycles Needed for Cardiovascular Protection: An Evidence-Based Hypothesis. Journal of Restorative Medicine, 3(1), 85-103. https://doi.org/10.14200/jrm.2014.3.0106
Prior JC. Progesterone Within Ovulatory Menstrual Cycles Needed for Cardiovascular Protection: An Evidence-Based Hypothesis. Journal of Restorative Medicine. 2014;3(1):85-103. doi:10.14200/jrm.2014.3.0106
Prior, Jerilynn C. "Progesterone Within Ovulatory Menstrual Cycles Needed for Cardiovascular Protection: An Evidence-Based Hypothesis." Journal of Restorative Medicine, vol. 3, no. 1, 2014, pp. 85-103.
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RRM Academy Synopsis
Review proposes ovulatory cycles may protect women's hearts
A 2014 review by hormone doctor Jerilynn Prior proposes the hypothesis that ovulatory cycles with normal progesterone may protect women from early heart attacks. She draws on monkey studies, group studies of women and one small trial. Ovulation problems can hide in regular cycles.
Key Findings
In six prospective studies of 436 women, the mean share with at least one ovulatory disturbance in a year was 49% (range 13–82%).
In cynomolgus monkeys, dominant females had approximately 3–5% cycles without ovulation and subordinate females 16–25%. Coronary atherosclerosis was greater in males and subordinate females.
Heidelberg EPIC followed almost 12,000 women for a mean of 10.8 years (82 heart attacks). Women with more than three miscarriages had an adjusted HR of 5.06, 95% CI of 1.26–20.29.
In Utrecht, 29% of women who had a heart attack and 14% of controls had at least one cycle without ovulation (P<0.02). There were 45 cases, each matched with three controls.
In a 3-month randomized trial of 34 healthy early postmenopausal women, forearm blood flow on progesterone ran about 15% above placebo, a nonsignificant difference.
Interpretation
The paper is a narrative review that proposes a hypothesis. The author says the review is by no means comprehensive. She states that no prospective data in women yet combine ovulation measures, risk factors, stressors and later heart attack. Monkey findings come from an animal model. The Utrecht study had 45 cases. The Heidelberg result rests on 82 heart attacks and a wide confidence interval. The trial enrolled healthy early postmenopausal women. The review leaves out PCOS (polycystic ovary syndrome, now also called PMOS).
RRM Context
Restorative reproductive medicine follows the ovulatory cycle as a sign of whole-body health. The review fits that view. A regular cycle length says little about progesterone. The author calls for studies that follow women with documented ovulatory disturbances.
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