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Women who started menstruating at the age of 11 or younger, or entered menopause before 47, face a higher risk of heart disease and stroke, according to a study published Tuesday.

Miscarriage, stillbirth, undergoing a hysterectomy, and bearing children at a young age were also associated with elevated odds of cardiovascular problems later in life, researchers found.

The findings are not the first to uncover a link between reproductive factors and cardiovascular diseases, and the data do not show a causal relationship, the authors cautioned.

But their findings do strengthen the association, and suggest that women with premature reproductive cycles or a history of adverse events should be frequently screened for heart trouble and conditions leading to blood clots.

The scientists drew data from a long-term health survey in Britain that monitored and tested more than a quarter of a million women from 2006 to 2016. The women’s average age was 56 when monitoring began.

More than four-fifths had been pregnant, and nearly half had two children. On average, they started having their periods at 13, and had their first child at 26. In 2016, two-thirds of the women had gone through menopause, at an average age of 50.

The study showed that women who began menstruating before the age of 12 faced a 10 percent greater risk of cardiovascular disease compared to those who were 13 or older.

For those who went through menopause before the age of 47, the risk for cardiovascular disease rose by 33 per cent, and for stroke alone by 42 per cent.

Miscarriages were likewise linked with a greater danger of heart disease, with each stillbirth increasing the risk by six per cent.

A hysterectomy was associated with a 20 per cent higher chance of developing heart disease, the team found.