Women who experience early or premature menopause are more vulnerable to long-term health risks like cardiovascular disease. Experts say that eating a heart-healthy diet, maintaining a healthy BMI, and exercising regularly are especially important for these women.
What is early or premature menopause?
Many women around the world go through early or premature menopause, some studies peg the number at almost 5-10%. Menopause between the age of 40-45 years is referred to as early menopause; if it happens before 40, it is called premature menopause.
Research suggests that the average age for menopause in India is 46.2 years; comparatively, the average age in the U.S. is 51 years. Women who are undergoing early or premature menopause will experience menopause symptoms like hot flashes, night sweats, anxiety, recurring urinary tract infections (UTI), vaginal dryness, difficulty in sleeping, and emotional changes like irritability and mood swings. These can last between 2-6 years.
The average age for menopause in India is 46.2 years; comparatively, the average age in the U.S. is 51 years.
Long-term health risks from early and premature menopause
Premature and early menopause have long-term health risks associated with it; these have been linked to a higher risk of heart disease, neurologic conditions, osteoporosis, and overall mortality. Delhi-based gynaecologist Anuradha Sharma says female hormones are protective. “They help keep your bones intact and your brain intact. Women who undergo early menopause are more prone to coronary heart disease, osteoporosis as your bones become weak, dementia, and cognitive impairment,” she says.
According to a study by the University of Queensland, early menopause puts women at greater risk of suffering a non-fatal cardiac event like heart attack, angina or stroke.
“Women under 40 who experience premature menopause were nearly twice as likely to have a non-fatal cardiovascular event before the age of 60,” says professor Gita Mishra, School of Public Health, University of Queensland. “This is compared to women who reach menopause between the ages of 50 or 51, during what is considered the standard developmental period. Women who were aged between 40 and 44 in menopause were 40% more likely to suffer from a cardiovascular condition.“
“Female hormones are protective and they help keep your bones intact and your brain intact. Women who undergo early menopause are more prone to coronary heart disease, osteoporosis as your bones become weak, dementia, cognitive impairment. There are a lot of problems. The incidence of these conditions becomes higher,” says Delhi-based gynaecologist Anuradha Sharma.
According to a study published by JAMA Cardiology (The Journal of the American Medical Association) in 2016, “the risk of cardiovascular disease (CVD) increases with age, and because women tend to live longer than men, the absolute number of women living with and dying of CVD is greater than the number of men”.
The meta study, which was based on 32 studies that included more than 300,000 women, says that early recognition of women at high risk for heart disease and timely implementation of lifestyle or therapeutic interventions are of great public health importance.
A more recent study, which researched the age of natural menopause and 11 chronic conditions (diabetes, hypertension, heart disease, stroke, arthritis, osteoporosis, asthma, chronic obstructive pulmonary disease, depression, anxiety and breast cancer), also found that women who had premature menopause were at a higher risk of these conditions and multimorbidity, which means having two or more of these conditions.
The researchers say this was the first study on premature menopause and development of multimorbidity in middle-aged women. “Health professionals should consider comprehensive screening and assessment of risk factors for multimorbidity when treating women who experienced premature menopause,” they recommend.
Another study, conducted last year, found that women who had experienced premature menopause were also more likely to develop conventional heart disease risk factors like high blood pressure, high levels of “bad” cholesterol and Type 2 diabetes.
Michael Honigberg, M.D., M.P.P., and the lead author of the study and a cardiology fellow at Massachusetts General Hospital and Harvard Medical School in Boston, said, “Women should make sure their physician knows their menopause history, particularly if they experienced menopause before age 40. History of premature menopause should prompt physicians to refine the patient’s estimated future risks for heart disease and to work toward lowering their heart disease risks.”
He recommended that eating a heart-healthy diet and exercising regularly are especially important for women with a history of premature menopause.
“Women should make sure their physician knows their menopause history, particularly if they experienced menopause before age 40. History of premature menopause should prompt physicians to refine the patient’s estimated future risks for heart disease and to work toward lowering their heart disease risks.”
So, what is the link between some of these diseases and early menopause. Menopause effectively means that a woman’s ovaries stop producing estrogen and other hormones at normal levels, they stop getting their menstrual period, and cannot get pregnant. A drop in estrogen means that the blood vessels and the heart become less elastic causing an increase in the blood pressure, which can put more strain on your heart. The lack of estrogen also means that the “good” cholesterol may go down while “bad” cholesterol goes up. It may also lead to insulin resistance.
In India, especially, where not all women have access to proper nutrition, this becomes particularly important. A study published in the Indian Journal of Medical Research in 2016 suggests that, “As early menopause is linked with osteoporosis and other health risks, it is important that poor women are assured access to appropriate nutrition and health interventions.”
- Association of Age at Onset of Menopause and Time Since Onset of Menopause With Cardiovascular Outcomes, Intermediate Vascular Traits, and All-Cause Mortality: A Systematic Review and Meta-analysis. Taulant Muka, MD, PhD; Clare Oliver-Williams, PhD; Setor Kunutsor, MD, PhD; Joop S. E. Laven, MD, PhD; Bart C. J. M. Fauser, MD, PhD; Rajiv Chowdhury, MD, PhD; Maryam Kavousi, MD, PhD; Oscar H. Franco, MD, PhD
- Age at Natural Menopause and Development of Chronic Conditions and Multimorbidity: Results From an Australian Prospective Cohort. Xiaolin Xu, Mark Jones, Gita D Mishra.
- Early menopause may raise the risk of several heart conditions. American Heart Association Scientific Sessions, Poster Presentation MDP451 (News release – American Heart Association).
- Natural menopause among women below 50 years in India: A population-based study. Saseendran Pallikadavath, Reuben Ogollah, Abhishek Singh, Tara Dean, Ann Dewey, William Stones