A recent study has linked premature menopause with a 40% higher lifetime risk of coronary heart disease, also finding that black women were more likely to experience premature menopause than white women, reports Everyday Health.
Doctors have known for some time that premature menopause and early menopause (before 45) can increase the risk of heart disease. But most studies have focused on short-term and mid-term risk, said lead study author Priya Freaney, MD, director of the Women’s Heart Care Programme at Northwestern University in Chicago.
“We wanted to understand what this means over the course of a woman’s entire life,” she said. “By looking at lifetime risk, we hoped to better capture the long-term impact of premature menopause on heart health and help inform prevention earlier in life.”
Raises lifetime heart disease risk
The latest research, published in JAMA Oncology, followed about 10 000 women for roughly 15 years on average. About one-third were black and the rest were white; the average participants were 61 and 60, respectively. None had heart disease when they entered the study.
Black women reported premature natural menopause more often (15.5% of participants) compared with white women (4.8%). Among the premature menopause group, black women were more likely to have a history of diabetes, while white women were more likely to be current smokers.
About 1 000 women went on to develop heart disease over the course of the study. Data analysis revealed that premature menopause was tied to a roughly 40% higher lifetime risk of coronary heart disease, regardless of race.
“The study helps put the magnitude of the risk into a clearer context for both clinicians and patients,” Freaney said. “Importantly, we also looked at this question in a diverse and inclusive sample of women, which allowed us to better understand how these patterns may differ across populations.”
The findings also reinforce that menopause timing isn’t just a reproductive issue: it’s also a heart health issue, she added.
What makes menopause happen early?
In the United States, women typically enter menopause between 45 and 55. Doctors define menopause as the day when 12 months have passed since a person’s last period. Estimates suggest about 5% of women go through early menopause, and 1% to 3% go through premature menopause.
Scientists don’t know why some women experience menopause early or prematurely, said Heather Hirsch, MD, an internal medicine physician, founder of the telemedicine platform The Collaborative, and author of The Perimenopause Survival Guide. Hirsch wasn’t involved with the new study.
Risk factors for early or premature menopause include genetics, smoking, autoimmune diseases, and poor metabolic health, she added.
“Unfortunately, we don’t yet have a reliable way to predict who will experience premature menopause – which is why simply asking women about the age of menopause is such an important part of medical care.”
How it raises heart disease risk
“The study wasn’t designed to pinpoint the biological mechanisms behind the link, so more research is needed to understand exactly why this relationship exists,” Freaney said.
The connection between heart disease and premature menopause could be related to “a mix of social, environmental, and health factors”, she added. Chronic stress, differences in access to care, and higher rates of certain health conditions all influence menopause timing.
It may also be tied to the early loss of oestrogen, said Stephanie Faubion, MD, director of the Mayo Clinic’s Centre for Women’s Health in Florida and medical director of the Menopause Society.
Menopause is marked by a sharp decrease in the ovaries’ production of this hormone, which aside from its reproductive functions, also helps promote heart, brain, and bone health, especially in younger women, said Faubion, who was not involved with the new research.
Oestrogen also supports vascular health, keeping blood vessels and arteries flexible, Hirsch added. Lower levels of the hormone can stiffen blood vessels and accelerate blockages.
She said hormone therapy has been shown to benefit heart health, and can also help manage symptoms like hot flushes, which can also decrease heart disease risk.
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