Reproductive Lifespan Linked to Cerebrovascular Disease Risk

Kelli Whitlock Burton

October 02, 2023


Women with longer reproductive lifespans and prolonged endogenous hormone exposure may be less likely to develop cerebral small vessel disease, regardless of their history of oral contraceptive use or hormone replacement therapy, a new study suggests.


  • 9163 postmenopausal female participants in the United Kingdom Biobank, average age of 64, and no history of cerebral small vessel disease at baseline

  • Self-reported information on reproductive health, such as age at first menstruation and start of menopause, number of pregnancies, oral contraceptive use, and hormone therapy

  • Participants received brain scans to estimate white matter hyperintensities, used as a biomarker of total burden of cerebral small vessel disease


  • Total endogenous lifetime hormone exposure was 39.8 years and median white matter hyperintensity volume (WMHV) was 0.0019

  • Women with higher endogenous lifetime hormone exposure showed smaller WMHV (P < .01).

  • Number of years pregnant and duration of the reproductive lifespan were independent contributors to WMHV (P < .001).

  • Exogenous lifetime hormone exposure was not significantly related to WMHV (P > .05).


"These results provide real-world confirmation of the protective effects pre-menopausal endogenous hormone exposure plays on postmenopausal cerebrovascular health," the authors write.


The study was conducted by Kevin Whittingstall, PhD, Diagnostic Radiology, Department of Medicine, Sherbrooke University, Sherbrooke, Canada. It was funded by Natural Sciences and Engineering Research Council of Canada and Fonde de Recherche du Québec–Santé and was published online September 27 in the journal Neurology.


The cohort was largely cisgender, White, affluent, and educated British females and may not be generalizable. No information was included on the type of oral contraceptive or hormone replacement therapy used, breastfeeding history, drug use, or alcohol use.


Co-author Christian Bocti, MD, holds stock options in Imeka. Whittingstall and the other co-authors report no relevant financial relationships.

For more Medscape Neurology news, join us on Facebook and Twitter


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.