The overlooked connection: Managing menstrual irregularities in chronic conditions - A scoping review

BackgroundMenstrual irregularities are frequently reported among women living with chronic conditions, yet menstrual health remains inconsistently assessed and poorly integrated into chronic condition management. The extent to which menstrual irregularities are reported, interpreted, and managed across chronic condition contexts has not been comprehensively synthesized.ObjectiveTo map the existing evidence on the prevalence, types, and management of menstrual irregularities among women of reproductive age with chronic conditions.Eligibility criteriaEligible studies included biological females aged 18-45 years with chronic conditions, including cardiovascular disease, chronic kidney disease, diabetes, inflammatory bowel disease, and liver disease, reporting menstrual irregularities.Sources of evidenceA scoping review was conducted in accordance with the Joanna Briggs Institute methodology and reported following PRISMA-ScR guidelines. Systematic searches of MEDLINE, CINAHL, Embase, Scopus, and Web of Science, along with grey literature sources, were conducted for English-language studies published from 2010 to 2025. Data was extracted and synthesized.Charting methodsFour independent reviewers used a standardized form to extract study design, population characteristics, chronic condition, menstrual irregularities, and key findings; discrepancies were resolved through consensus.ResultsTwenty-six studies from 15 countries met the inclusion criteria. Across categories of chronic condition, the most reported menstrual irregularities included amenorrhea, oligomenorrhea, polymenorrhea, and menorrhagia, and were consistently associated with adverse cardiometabolic, inflammatory, and quality-of-life outcomes. Reported interventions were heterogeneous and largely symptom-focused, with limited attention to underlying systemic or hormonal mechanisms.ConclusionsMenstrual irregularities are common among women with chronic conditions and may serve as early clinical markers of systemic dysfunction and disease progression. Integrating standardized menstrual assessment into chronic condition management represents an important opportunity to improve early detection, risk stratification, and patient-centered care. Future research should prioritize longitudinal and interventional studies to inform evidence-based, multidisciplinary models that embed menstrual health as a core component of chronic condition care.