Women experience menopause around 51 years old, on average. But combing through 32 studies involving 310, 000 women, researchers in the Netherlands concluded menopause before the age of 45 may increase risk for cardiovascular disease and death.
From the interview with Dr. Nina Asrani, a cardiologist with Consultants in Cardiology and on the Texas Health Fort Worth medical staff:
The researchers did not find clear reason for health risks stemming from early menopause. What might possibly cause this? “We don’t entirely know the answer and that’s a great area for potential research. But what we think is happening is that menopause is the loss of estrogen function for women and that that the hormonal change is significantly related to potential increases in vascular inflammation and vascular damage.”
For instance? “Coronary heart disease or blockages in the arteries that feed the heart muscle, as well as an increased risk of stroke. And there are also impacts that estrogren has in terms of some of the kidney hormone processes that can result in increased risk for hypertension, which we know is an increased risk for future cardiac events.”
Do we know why going through menopause earlier would make this kind of difference? “Premature menopause is defined as before the age of 40. Early onset menopause is before the age of 45. There have now been several studies looking at women and trying to divide them into age groups - before age 45 and then looking at potentially happens at the age of 50 and beyond that. What we see in this study and in other studies is that when they compare women age 45 and younger who’ve had the onset of menopause, and compared them to their older peers at menopause, those younger women do have an increased risk in heart disease in terms of both non-fatal and fatal heart-related events. And they do have an increased risk of stroke, which is was seen in this study. When they look at those women and divide the age at 50, those differences are no longer there. And so there is something about the early onset of menopause that specifically affects those women differently. We don’t know what triggers early menopause for women. So it may not be the menopause itself is what’s causing the heart-related events. It may be that there some other either genetic or environmental factor that these women experience that makes them more likely to have the early menopause, and also makes them more likely to have these subsequent cardiac events.”
Is there any way to guard against that increased heart risk? “The best advice we have at this stage is the same advice for everyone in the population: Women need to be aware that they also do have heart disease. (“Many people thought it was only a man’s disease?”) Absolutely right. And that it’s the number one killer of women. But beyond that, for these women who have early menopause, we need both the women and the medical community now to recognize that perhaps as an independent risk factor, that for women who have had early menopause, that means that their risk of having a future cardiac event is increased and that we need to be more aggressive about treating their other risk factors. So things like hypertension, cholesterol levels, diabetes. If you’re a smoker, trying to quit.”
Family history plays a role as well? Absolutely, and it’s especially important in these young women because when you look at a younger woman’s overall risk by the calculators that we use, her risk is going to be low, primarily because she’s a woman and her age. But having an early family history of heart-related events, whether it’s male or female relatives is an important predictor.”