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more than four times the risk of endometrial hyperplasia (precancer of the uterus) and more than 2.5 times the risk of uterine cancer. • 5.7 percent of participants reported their cycles taking five or more years to reach cycle regularity after their first period. Participants in that group had more than twice the risk of endometrial hyperplasia and more than 3.5 times the risk of uterine cancer, compared to those who reported their cycles took less than one year to reach regularity. These updates are a first step for helping people understand risk factors for these diseases, and encouraging people to have conversations with their healthcare providers about cycle irregularity earlier. “More awareness on menstrual cycle physiology and the impact of irregular periods and PCOS on uterine health is needed,” said Dr. Shruthi Mahalingaiah, MS, Harvard Chan School’s assistant professor of Environmental Reproductive and Women’s Health and co-principal investigator of the Apple Women’s Health Study. “This analysis highlights the importance of talking to a healthcare provider when menstruators are experiencing persistent changes to their period that span many months. Over time, we hope our research can lead to new strategies to reduce disease risk and improve health across the lifespan.” The study team will conduct further analyses on this preliminary data for scientific publication. Previous Interim Updates The Apple Women’s Health Study team has previously shared a number of other interim research updates that highlight how large-scale, longitudinal research on menstruation can help advance the science around this topic. • Research published in the American Journal of Obstetrics and Gynecology focuses on cycle deviations, like irregular or prolonged periods, which can be a sign of underlying conditions including PCOS, fibroids, malignancies, or infections. The study found cycle deviations were found in 16.4 percent of the study population. Black participants had a 33 percent higher prevalence of infrequent periods compared to white, non-Hispanic participants, while Asian participants had a higher prevalence of irregular periods. • Demonstrating just how common menstrual symptoms really are, researchers found the most frequently tracked symptoms were abdominal cramps, bloating, and tiredness, all of which were experienced by more than 60 percent of participants who logged symptoms. More than half of the participants who logged symptoms reported acne and headaches. Some less widely recognized symptoms, like diarrhea and sleep changes, were also tracked by 37 percent of participants logging symptoms. • After analyzing over 125,000 menstrual cycles, researchers found that participants experienced