Women who enter menopause before the age of 40 face around a 40% higher risk of developing coronary heart disease over their lifetime compared with those who experience menopause later, according to a large study by the US healthcare system Northwestern Medicine.
Menopause is defined as one year after a woman’s final menstrual period, with the average age in the United States being 51. Researchers classify menopause before the age of 40 as premature, and between 40 and 45 as early.
Causes remain unclear
The causes of premature menopause are not fully understood. They are believed to involve a combination of genetic, biological and environmental factors, as well as lifestyle influences such as smoking, obesity and chronic stress.
The findings, published in JAMA Cardiology, are based on data from more than 10,000 women in the United States who participated in six long-term studies and were followed between 1964 and 2018.
Even after accounting for major risk factors including smoking, obesity, hypertension and diabetes, premature menopause remained associated with a significantly higher risk of coronary disease.
The increase in risk was measured at 41% for Black women and 39% for white women.
Disparities and underlying factors
The study also found that premature menopause is three times more common among Black women than white women, with rates of 15.5% compared to 4.8%.
Researchers suggest that this disparity reflects a complex interaction of health conditions and structural inequalities, rather than purely biological differences.
Hormonal changes and cardiovascular impact
It remains unclear whether menopause itself directly contributes to cardiovascular disease or whether women who experience premature menopause already have an underlying risk profile.
However, hormonal changes associated with menopause, particularly the decline in oestrogen levels, are known to affect cardiovascular health and increase the likelihood of coronary disease.
A gap in medical practice
The study highlights a broader issue in clinical practice: menopause is still largely treated as a gynaecological matter, despite its systemic effects on the body, including the cardiovascular system.
Researchers argue that doctors should routinely ask women about the age at which they entered menopause, in order to better identify those at higher risk and enable earlier intervention.
Source: CNA