Early menopause tied to heart problems before 60

(Reuters Health) - Women who go through menopause earlier in life may be more likely to have a heart attack or stroke before they reach age 60 than their counterparts who go through menopause later on, a recent study suggests.

Researchers examined data from 15 observational studies with a total of more than 300,000 women, including almost 13,000 women who survived events like a heart attack or stroke after menopause.

Compared with women who went through menopause at age 50 or 51, women who experienced premature menopause, before age 40, were 55% more likely to have events like a heart attack or stroke after menopause. With early menopause, from age 40 to 44, women had a 30% greater risk of cardiovascular events after menopause; with relatively early menopause, from age 45 to 49, the increased risk was 12%.

“Heart disease is a leading cause of illness and death for women,” said senior study author Gita Mishra of the University of Queensland in Brisbane, Australia.

“These findings will help to identify women at most risk of cardiovascular disease for closer monitoring and earlier diagnosis and even prevention of the disease,” Mishra said by email.

Women go through menopause when they stop menstruating. As the ovaries curb production of the hormones estrogen and progesterone, women can experience symptoms ranging from vaginal dryness to mood swings, joint pain and insomnia.

Earlier menopause has previously been linked to an increased risk of heart disease, osteoporosis, diabetes and sleep problems. It can also leave women with fewer reproductive years, particularly when it’s preceded by premature ovarian failure, when the ovaries stop working before age 40.

In the current study, women were 50 years old on average when they went through menopause. Only 1.2% of the women in the study had premature menopause before age 40; and 4.7% experienced early menopause from age 40 to 44.

Among women who had events like a heart attack or stroke after menopause, an average of 13.5 years passed between menopause and these cardiovascular events, researchers report in the Lancet Public Health.

Compared to women who didn’t experience events like a heart attack or stroke, women who did were less likely to be educated, and more likely to be obese, and current smokers with a history of high blood pressure.

The study wasn’t a controlled experiment designed to prove whether or how menopause timing might directly impact cardiovascular health.

One limitation of the analysis is that many of the cardiovascular events were self-reported by study participants, not confirmed by medical records. It’s also possible that use of hormone therapy after menopause may have impacted the results, the study team notes.

Still, the results highlight a need for women to be hypervigilant about heart health if they go through menopause earlier in life, Mishra said.

“For women who are experiencing earlier menopause, active management of other risk factors for cardiovascular disease, such as avoiding cigarette smoking and maintaining a healthy body weight are all the more important for reducing their overall risk of cardiovascular disease,” Mishra advised. “These women may also consult with health professionals for regular monitoring of their risk of cardiovascular disease.”

SOURCE: Lancet Public Health, online October 3, 2019.