Early Menopause Raises Heart Disease Risk

Early Menopause Raises Heart Disease Risk
When a woman going through menopause gets hot flashes, even a fan such as this may not help her feel cooler. Photo courtesy Flickr.com/Rocco.

Different women reach menopause at different ages, and those who experience menopause earlier may have advantages or disadvantages as their reproductive days end. Now researchers have found a major downside to early menopause, with a link to cardiovascular disease and early death.

The study comes from Taulant Muka, M.D., Ph.D. of the Erasmus University Medical Center in Rotterdam, the Netherlands, along with other researchers. The researchers published their findings September 14th in the journal JAMA Cardiology. Early menopause is considered to be before the age of 45, and the researchers reviewed previous studies to determine if this has an effect on cardiovascular disease and early death.

For their study, the researchers analyzed data from 32 different studies, dating back to the 1990s and involving 310,329 women. The researchers divided the women into the early menopause group, which is under the age of 45 at the onset of menopause, and the average menopause group, over the age of 45 at onset. The researchers also analyzed the difference between women between 50 and 54 at the onset of menopause to women under the age of 50, to see if those groups had any differences. Data included if the women developed coronary heart disease (CHD), if they developed coronary heart disease that led to death, if they had a stroke, if they died from a stroke, if they died of cardiovascular disease (CVD), or if they died of any cause. Coronary heart disease involves the buildup of plague on artery walls, which can lead to chest pain, heart attacks, and strokes.

When they crunched their numbers, the researchers discovered that women who had early menopause, before the age of 45, were about 50 percent more likely than their peers to have coronary heart disease, 20 percent more likely to die of cardiovascular disease such as heart attack and stroke, and 12 percent more likely to die in general from any cause. However, the researchers did not find a link between early menopause and increased risk of stroke. The researchers also discovered that women who experienced menopause between the ages of 50 and 54 years at onset had a decreased risk of dying from coronary heart disease than their peers under the age of 50. The findings seem to suggest that going through early menopause increases the risk of heart disease and of dying early, and going through menopause over the age of 50 decreases heart disease death risks.

The authors do point out some limitations in their study, with some of the research they looked at seeming to have inconsistent results. The scientists call for more research into the subject to confirm the link between early menopause and cardiovascular disease, and to discover why the link exists.

The researchers speculate the link between early menopause and heart disease may have to do with hormones. After menopause, hormone levels drop, which could have far-reaching effects on a woman’s body. Alternatively, early menopause could simply be a sign of aging, with these women’s bodies aging earlier than their peers’ bodies, including aging hearts and blood vessels. An aging heart is more susceptible to heart disease and aging blood vessels may be more likely to be clogged or damaged, leading to heart attack or stroke.

While the news may not be encouraging to women who have experienced early menopause, the study findings could be helpful. Knowing that early menopause leads to cardiovascular disease risks, doctors could intervene and help these patients reduce their risk of heart disease and stroke in other ways. For example, quitting smoking, eating healthier, and exercising can help improve heart health, and if needed, doctors could prescribe drugs to help control cholesterol or blood pressure.

These study findings may also indicate the need for hormone therapy when a woman experiences menopause before the age of 45. In hormone therapy, drugs can help supplement levels of certain hormones that drop after menopause. By upping these hormone levels, doctors can reduce the impact of hormone drops, helping protect a woman’s bones and vascular health and reducing bothersome symptoms such as hot flashes. Although the effect of hormone replacement therapy on a woman’s health remains controversial, the benefits may outweigh the risks in the early menopause group, some suggest.

The average age of menopause onset is 51, with onset usually signaled by the lack of a menstrual period. However, ten percent of women may start menopause before the age of 45. Other studies have found that women who begin menstruating later and have menopause later are more likely than their peers to reach the age of 90. While some women may enjoy no longer having to worry about their menstrual period after menopause, they may face more health problems and a shorter life according to research.

The studies looked only at women who experienced natural menopause, which is menopause that occurs naturally through the decline of estrogen and progesterone hormones, and not due to the removal of the ovaries or other interventions. Menopause is defined as beginning twelve months after a woman’s last menstrual period, since a woman may miss a period now and then, and periods may become irregular before stopping totally. During perimenopause, which could last months or years before the onset of menopause, women may experience symptoms such as irregular periods, hot flashes, night sweats, problems sleeping, vaginal dryness, lost of breast fullness, mood changes, thinning hair, dry skin, and weight gain or slow metabolism.

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