Abstract Background Hormonal changes throughout life in women are associated with menarche, pregnancy, lactation, and menopause. Cardiometabolic multimorbidity (CMM) has become increasingly common with population aging. However, the impact of such fluctuations on CMM has not been evaluated. This study aims to investigate the associations of female sex-specific risk factors with CMM and four cardiometabolic diseases. Methods A total of 248,623 women from the UK Biobank without pre-existing cardio