Vollmar, A. K. R., Mahalingaiah, S., & Jukic, A. M. (2025). The Menstrual Cycle as a Vital Sign: a comprehensive review. F&S reviews, 6(1). https://doi.org/10.1016/j.xfnr.2024.100081
Vollmar AKR, Mahalingaiah S, Jukic AM. The Menstrual Cycle as a Vital Sign: a comprehensive review. F&S reviews. 2025;6(1). doi:10.1016/j.xfnr.2024.100081
Vollmar, A. K. R., et al. "The Menstrual Cycle as a Vital Sign: a comprehensive review." F&S reviews, vol. 6, no. 1, 2025.
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2 institutions
Department of Obstetrics & Gynecology, Boston University Medical Center, Boston, MA.05qwgg493
National Institute of Environmental Health Sciences00j4k1h63
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RRM Academy Synopsis
The menstrual cycle is a vital sign through menopause, a review argues
A 2025 literature review argues the menstrual cycle is a vital sign through menopause. The authors searched PubMed for reviews and guidelines. They describe links between cycle patterns and later cancer, diabetes and heart disease, and between the cycle and other conditions.
Key Findings
The authors borrow a published definition of a vital sign: a patient feature that predicts outcome, signals a need for treatment, or tracks the clinical course. They argue the cycle fits it.
One prospective cohort study (n=78,943) reported 11% (95% CI: 2%, 21%) higher risk of any cancer and 23% (95% CI: 9%, 39%) higher risk of obesity-related cancer with irregular cycles.
Compared with regular cycles, irregular cycles carried 17% to 66% higher risk of type 2 diabetes, and people with irregular cycles were 1.5 times more likely to develop gestational diabetes.
Irregular cycles were associated with 8% to 40% higher risk of cardiovascular disease, and long or short cycles with 11% to 44% higher risk.
One study of premature death (n=79,505) linked irregular and long cycles to 18% to 40% higher risk of dying before age 70, with higher risk for older menstruators.
Interpretation
The paper is a literature review. The authors gather findings from other studies and report no new data. The long-term links come from observational cohorts. Cohorts show association and leave cause open. Two cohorts kept their type 2 diabetes and cardiovascular links after restricting to people without a polycystic ovary syndrome (PCOS, now called PMOS, polyendocrine metabolic ovarian syndrome) diagnosis, though one cardiovascular link weakened. Undiagnosed PCOS may help explain some of these diabetes and cardiovascular associations. The authors say data are lacking to support cycle phase-specific nutrition and exercise plans at the population level.
RRM Context
The authors note that two US medical groups have advocated the cycle as a vital sign for adolescents since 2006. They extend the case to adulthood. Restorative reproductive medicine is cycle-charting-informed: records kept over many cycles show patterns that one cycle cannot. The review names basal body temperature and cervical fluid as signs that identify ovulation in retrospect.
Our editorial summary of this paper, not the article's abstract.
Abstract
Some medical professional organizations have advocated for including the menstrual cycle as a vital sign in adolescence, but not in adulthood. However, documenting menstrual cycle patterns is not routine clinical or research practice. Vital signs are used to predict health outcomes, indicate needed treatment, and monitor a clinical course. They can help identify pathologies, affirm wellness, and are responsive to exposures. Here we review the scientific evidence showing how the menstrual cycle meets these criteria and should therefore be treated as a vital sign. Using key words and controlled vocabulary terms, we carried out multiple literature searches, prioritizing the inclusion of systematic reviews, meta-analyses, and clinical practice guidelines. This review describes how the menstrual cycle is a health indicator, can cyclically impact health conditions, and its associations with long-term post-menopausal health outcomes. We review exposures influencing the menstrual cycle, evidence underlying its use to optimize wellness, and available tools for documenting cycles. Supplementary materials include patient handouts on menstrual cycle tracking, and an index of related clinical practice guidelines and reviews by subject. The menstrual cycle is a vital sign from menarche through menopause, an underutilized but powerful tool for understanding gynecological and general health.
