Women who go through early menopause are at higher risk of heart disease and stroke, research has shown.

A study led by the University of Oxford also found a link between starting periods early, pregnancy complications and hysterectomy with cardiovascular disease.

Women who went through the menopause before the age of 47 had a 33 per cent heightened risk of cardiovascular disease, rising to 42 per cent for their risk of stroke, they found.

Those who began having periods before the age of 12 were at 10 per cent greater risk of cardiovascular disease than those who had been 13 or older when they started, the study said.

Previous miscarriages were associated with a higher risk of heart disease, with each miscarriage increasing the risk by six per cent.

And having a stillbirth was associated with a higher risk of cardiovascular disease in general (22 per cent) and of stroke in particular (44 per cent).

The study, which is published in the journal Heart, found having a hysterectomy was linked to a heightened risk of cardiovascular disease (12 per cent) and of heart disease (20 per cent).

And those who had had their ovaries removed before a hysterectomy were twice as likely to develop cardiovascular disease as those who had not had these procedures.

Cardiovascular disease, a general term for conditions affecting the heart or blood vessels, remains the leading cause of death and disability  worldwide in both men and women, but it can often largely be prevented with a healthy lifestyle.

Scientists said previous research has suggested that certain reproductive risk factors may be linked to an increased risk of heart disease or stroke, but the findings have been mixed.

For their study, the team drew on data from the UK Biobank, a large population-based study of more than half a million men and women up to the age of 69, who were recruited between 2006 and 2010.

Participants filled in questionnaires on their lifestyle, environment and medical history, which included a wide range of reproductive factors.

They also took tests to assess their physical and functional health and provided urine, blood and saliva samples.

In all, the health of 267,440 women and 215,088 men – none of whom had cardiovascular disease when they entered the study – was tracked up to March 2016 or until they had their first heart attack or stroke, if this happened before then.

Analysis of the data showed that after taking account of potentially influential factors, women who had started having periods before the age of 12 were at 10 per cent greater risk of cardiovascular disease than those who had been 13 or older when they started.

Cardiovascular disease remains the leading cause of death and disability worldwide in both men and womenbut it can often be prevented

The average age of the women at the start of the study was 56, and around half (51 per cent) came from the most affluent third of the UK population. Six out of 10 (60 per cent) had never smoked.

The average age at which they had started having periods was 13, most (85 per cent) had been pregnant and nearly half (44 per cent) had two children. On average, they were 26 when they had their first child.

One in four (25 per cent) of the women had miscarried and three per cent had experienced a stillbirth. Nearly two-thirds (61 per cent) of the women had gone through the menopause, at an average age of 50.

Meanwhile, four out of 10 of the men (42 per cent) had fathered two children.

They found that during a monitoring period spanning around seven years, 9,054 cases of cardiovascular disease were recorded, a third (34 per cent) of which were in women. This included 5,782 cases of coronary artery disease (28 per cent of women) and 3,489 cases of stroke (43 per cent women).

Young age at first parenthood seemed to be another risk factor, with each additional year of age lessening the risk of cardiovascular disease by around three per cent. But the association between the number of children and cardiovascular disease was similar for men and women, suggesting that the social, psychological and behavioural issues associated with bringing up children may be more important than biological factors.

The team, which was led by Sanne Peters of the George Institute for Global Health at the University of Oxford, said theirs was an observational study, so no firm conclusions can be drawn about cause and effect.

But they added the study was large and they were able to account for a range of potentially influential factors.

“This large, prospective study found that early menarche, early menopause, earlier age at first birth and a history of miscarriage, stillbirth or hysterectomy, were each associated with a higher risk of CVD in later life, after controlling for key cardiovascular risk factors,” they said.

“Women who had given birth to more children also had higher subsequent CVD risk  but this is unlikely to have been due to a biological cause, as some have hypothesised, because a similar effect was found when analysing the number of children fathered by men.

“More frequent cardiovascular screening would seem to be sensible among women who are early in their reproductive cycle, or who have a history of adverse reproductive events or a hysterectomy, as this might help to delay or prevent their onset of CVD,” they concluded.

Risk factors

1. Early periods, pregnancy and hysterectomy procedures are linked to heart diseases

2. Attaining menopause before the age of 47 increases the risk of cardiovascular disease by 33%

3. Similarly, attaining puberty before the age of 12 increases the risk by 10%

4. Each miscarriage increases the risk of contracting a cardiovascular disease by 6%

5. Having a stillborn child may also lead to heart-related illnesses and stroke in particular