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Premature menopause may increase risk of death from heart disease, cancer

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Researchers say there are serious health impacts for women who go through menopause before the age of 40. Westend61/Getty Images
  • Researchers report that women who enter menopause before age 40 are twice as likely to die from heart disease and four times as likely to die from cancer.
  • Their study compared the health records of 5,800 women who entered menopause before age 40 to 23,000 women who didn’t.
  • Experts say hormone replacement therapy should be considered among treatments for early menopause as well as surgically induced menopause.

Women who enter menopause before the age of 40 are more likely to die at a younger age, according to research from Finland presented at the 26th European Congress of Endocrinology.

Experts point out, however, that this increased mortality risk also affects women beyond those who’ve experienced premature menopause.

“This research confirms what we already know and believe in the gynecology profession,” explained Dr. Vanessa Soviero, an OB/GYN from the Katz Institute of Women’s Health at Northwell Health who was not involved in the study.

Soviero stressed the need for deeper research on women’s health — a historically underserved area. While only 1% of women experience premature menopause, also known as primary ovarian insufficiency (POI), Soviero said this research applies to other women, too.

“It isn’t just women who experience early menopause,” Soviero told Medical News Today. “Women who’ve had their ovaries removed at a young age also face these risks.”

A woman may need one or both ovaries removed for reasons that include endometriosis and non-cancerous growths (cysts) as well as those women who have had preventive surgery because they have a significantly higher risk of breast cancer or ovarian cancer. 

Details on the study of premature menopause

Researchers from the University of Oulu and Oulu University Hospital in Finland examined about 5,800 women who had been diagnosed with spontaneous or surgically-induced POI between 1988 and 2017.

They compared the results to nearly 23,000 women without POI.

Their findings, which haven’t been published yet in a peer-reviewed journal, conclude that women with POI are twice as likely to die from heart disease and four times as likely to die of any type of cancer. They were also listed as twice as likely to die from any cause.

There was no notable difference in a woman’s risk of death between those with naturally occurring POI versus surgically induced POI.

While past studies have focused on the relationship between premature menopause and a woman’s risk of death, this study is the largest to date. It’s also the first to include surgically induced menopause.

“To our knowledge, this is the largest study performed on the linkage between premature ovarian insufficiency and mortality risk,” explained Hilla Haapakoski, the study’s lead author and a PhD student at the University of Oulu in a press statement.

While past research has shined a light on the relationship between menopause and heart health — regardless of the woman’s age — menopause before age 40 poses considerably more risks.

“The risks are highest in women who go through menopause before 40, but every woman should consider taking hormones, even before entering menopause,” said Soviero.

“I encourage women to start [hormone replacement therapy] before going into menopause when you start developing symptoms of perimenopause,” said Soviero. “The earlier you start hormone therapy, the more you [receive] the cardiac, cognitive, and bone health benefits.”

Hormone replacement therapy and premature menopause

“In our practice, we recommend birth control pills to anyone with POI or who’s had their ovaries removed because it reduces all of the risks associated with low estrogen,” explained Soviero.

In their study, researchers reported that women who used hormone replacement therapy for at least six months were 50% less likely to die from cancer or other causes.

“Women can lower their risk with birth control, but many women think they don’t need birth control in menopause because they can’t get pregnant,” said Soviero. “Hormone therapy will reduce your risk of heart attack and stroke, but it will also reduce your risk of cognitive disorders, too, like dementia and Alzheimer’s, and osteoporosis and fractures.”

Soviero said she educates her patients to combat common misconceptions about birth control, hormones, and HRT.

“Most people don’t understand the benefits of hormones, particularly estrogen,” said Soviero. “And they’ve seen things on social media that aren’t accurate for most women. Estrogen and progesterone should both be considered.”

After menopause, estrogen protects your heart, brain, and bone health, said Soviero. Progesterone protects your uterus.

Women who shouldn’t consider hormone therapy include anyone with a history of breast cancer, uterine cancer, or blood clotting disorders.

Despite some risks associated with hormone replacement therapy, Soviero said the benefits of HRT Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source outweigh the risks.

The researchers said their next steps include assessing the long-term impact of hormonal therapy.

“Various health risks of women with premature ovarian insufficiency have not been well recognized and the use of [hormone replacement therapy] is often neglected,” said Haapakoski. “We hope to improve the health of these women by increasing awareness of the risks among healthcare professionals and the women themselves.”

This article originally appeared on Medical News Today.

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