Menstrual problem can make women to develop hypertension

Menstrual problem is common
among women of reproductive
age group. The causes of persistent high blood pressure or hypertension vary considerably among communities. Experts in the study of hypertension found that women that experience premenstrual syndrome, a variety of physical and psychological symptoms that occur just before their menstrual period, have a higher risk of developing hypertension, reports Sade Oguntola.

It was obvious that Kemi was not feeling well. The symptoms Kemi was having were familiar to what her mother also once had before she was married. Kemi was tired, had a headache and ill-tempered. Her breasts were tender, she had trouble concentrating too long while reading and pimples were all over her face.

Many young girls suffer the same fate as Kemi before their menses start. What they were experiencing is what is commonly called premenstrual syndrome (PMS). It is a medical condition that affects many women of childbearing age, causing a variety of physical and psychological symptoms that occur just before their menstrual period.

The exact cause of PMS is unknown, but it seems to be related to the fluctuating levels of hormones, including oestrogen and progesterone, that occur one or two weeks prior to menstruation. There are many symptoms of PMS, and the number and severity of symptoms vary from woman to woman as well as from one month to another. These include abdominal bloating, pimples, breast tenderness, constipation, tiredness, weight gain and headache.

However, there are new findings suggesting an association between premenstrual syndrome and development of hypertension later in life due to the associated stress arising from the symptoms of premenstrual syndrome. The stress makes the blood pressure to be raised and as such, could be predictive of those to develop hypertension later in life.

The researchers were initially out to find out if PMS had any influence on development of hypertension considering the fact that people who develop hypertension later in life had also initially had a blood pressure that was above what can be termed normal for them.

Writing in the 2008 edition of the African Journal of Medicine and Medical Sciences, University of Jos researchers using questionnaires tried to examine the experience of all females from all levels of medical faculty of the university as well as their counterpacts in the Schools of Nursing and Medical Laboratory Technology based in the Jos University Teaching Hospital on PMS.

According to the study which lead author was Professor Basil Okeahialam, the increase in blood pressure some few days prior to the start of their menstrual bleeding may be related to the increased stress and heightened perception of stress felt by those with PMS alongside their menstrual cycle.

They wrote, “Stress is known to increase blood pressure. More patients with PMS had anxiety and depression in comparison to those without anxiety and depression as consequence of stress triggers increased production of hormones in the body that results in blood pressure rise. This may later be persistent.”

“Given the possibility of the raised blood pressure becoming persistent, it would not be a surprise to find PMS more in a female hypertensive patient. As such, we suspect that PMS may constitute a factor that might be helpful in identifying those women with strong predisposition to later development of hypertension.”

Taking account of this while treating women with hypertension, they suggested should also improve their blood control better, thus reducing ill health and deaths associated with hypertension.

Dr. Akin Sodipo, the medical consultant in charge of Comfort Medical Centre, Total Garden, Ibadan, Oyo State, said this might be a finding that women that experience PMS or what he also referred to as premenstrual tension, should be aware of because it may be an indication that they stand a higher chance of developing hypertension later in life.

Even though PMS is a natural phenomenon, he said that the link between the two medical conditions should be further probed, adding that those women that participated in the study should be more careful to take precautionary measures of regularly measuring their blood pressure and seeking medical attention when they find blood pressure is raised.

Dr. Oyinda Adeyemi, the medical consultant in charge of TZ Hospital, Idi-Ape, Ibadan, stated that considering the fact that PMS usually eases out after childbirth, for the researchers to infer that it may be of use in picking out women that may end up with hypertension may not really be so.

According to her, “I do not see how, this will further influence hypertension later in life since PMS eases out after childbirth, especially because women that have passed through childbirth tend to cope better with pain associated with PMS.”

Dr. Babatunde Salako, a consultant physician at the University College Hospital (UCH), Ibadan, Oyo State, said that it was not too common for people with PMS to have raised blood pressure.

He added that in women with PMS, the increased blood pressure might have been due to anxiety associated with when the menstrual bleeding will start.

“They are expecting their menstruation and in this condition, the changes in the body may cause the blood pressure to go up. The pain may also lead to increase in blood pressure. The tension and anxiety associated with PMS can lead to production of hormones in them, which then lead to increased blood pressure. But where elevated blood pressure is sustained, there may be the need to study such cases further.

Dr. Salako said that to say that PMS should be used as a determinant of those that may later have hypertension is a hypothesis. “They have suggested that there is a link between PMS and hypertension. However, hypertension is a disease that is caused by several factors and as such, all of those factors know to be risk factors for hypertension would come to play in determining those that would later have hypertension in life.

“Many have family history for hypertension, are obese and once all theses factors come together, the risk of hypertension is higher. So in order to be sure that what they suggested is correct, they need to follow up these female students and continually measure their blood pressure to be sure.”

The causes of persistent high blood pressure or hypertension vary considerably among persons in a large community or nation. This is because the disease is complex and with many risk factors such as age, gender, nutrition, environment, stress, obesity and heredity interacting to determine those that may have a raised blood pressure.

He advised that in those with PMS, they should also try to rule out other risk factors for hypertension that they have in order to prevent the diseases as well.

However given the possibility of the raised blood pressure could becoming persistent even in persons with PSM, the authors of the study were of the opinion that PMS would be of great public health importance in identifying women with a stronger predisposition to later develop hypertension with a view to preventing or delaying the onset of hypertension.