SUMMARY
Chrisandra Shufelt M.D., M.S., investigates the intersection between hormones and heart disease across the life span of women. Dr. Shufelt is the principal investigator on a National Institutes of Health (NIH)-funded study on young women with functional hypothalamic amenorrhea — the absence of menstrual cycles related to disorders of the hypothalamus. This condition occurs during reproductive years and results in amenorrhea, low estrogen and infertility, which can be prolonged from months to years. Functional hypothalamic amenorrhea results from a combination of psychosocial stress, anxiety, high levels of physical activity or weight loss. Emerging data from Dr. Shufelt's initial work has identified that one-third of young women with this condition have endothelial dysfunction, a preclinical marker for heart disease. Her team is further investigating the impact of hypothalamic amenorrhea on heart health and the immune system based on the underlying cause.
Another area of Dr. Shufelt's research focuses on women's health during midlife. She uses large epidemiology trials to understand the impact of hormones, menopause and cardiovascular disease. Dr. Shufelt has published data using the Women's Health Initiative (WHI) and the Women's Ischemia Syndrome Evaluation (WISE) cohorts. The data evaluates menopause and menopause hormone therapy in relation to cardiovascular disease. She is also co-investigator on the Data Registry on Experiences of Aging, Menopause and Sexuality (DREAMS), and Hormones and ExpeRiences of Aging (HERA). These Mayo Clinic women's health databases help to further investigate the experience of menopause beyond physiology. With the help of these databases, Dr. Shufelt examines the role the environment, relationships, workplace, psychological health and emotional health has on women's health.
Focus areas
- Reproductive hormones and cardiovascular disease in women. Dr. Shufelt's expertise focuses on the role of endogenous reproductive hormones, oral contraceptives and menopause hormone therapy in cardiovascular risk factors and cardiovascular disease.
- Vascular studies in women. Dr. Shufelt has focused on noninvasive vascular testing as a measure of preclinical cardiovascular disease in women. Her research team has successfully carried out protocols utilizing noninvasive vascular testing in participants, including children, with hypothalamic amenorrhea, cardiovascular disease, HIV and AIDS.
- Digital medicine using remote patient monitoring, patient-reported outcomes and cardiovascular disease. Dr. Shufelt's research employs wearable devices and digital technology to collect patient-reported outcomes, allowing precision medicine real-world investigation. She has successfully enrolled, retained and evaluated large sample sizes of participants with stable ischemic heart disease and women with hypothalamic amenorrhea.
Significance to patient care
Using the menstrual cycle as a vital sign is an opportunity to identify and prevent conditions. Such conditions include heart disease in the preclinical stages — where physiological changes are occurring, but symptoms have not yet started. Functional hypothalamic amenorrhea is an underrecognized and undertreated condition in young women. It is estimated to account for one-third of secondary amenorrhea that can be prolonged from months to years. This important research will benefit patient care by focusing on the menstrual cycle during the reproductive years and how it provides insight into women with, or at risk of, future heart disease.
Professional highlights
- Associate director, Women's Health Research Center, Mayo Clinic, 2022-present.
- Deputy editor, Contemporary Clinical Trials, 2020-present.
- North American Menopause Society.
- Member, board of trustees, 2018-present.
- Past-president, 2021-2022.
- Editorial board member, Menopause Journal, 2018-present.
- Fellow, American College of Physicians, 2012-present.