Early menopause predictor of heart disease

According to a new study from the University of Queensland, women who experience menopause before reaching 50 years of age face an increased risk of cardiovascular disease.

 Senior author of the study, Professor Gita Mishra, commented that the findings demonstrated early menopause puts women at a higher risk of suffering a non-fatal cardiovascular event, such as heart attack, angina or stroke. The research involved insights from more than 300,000 women involved in 15 studies from around the world.

 Professor Mishra added: “Women under 40 who experience premature menopause were nearly twice as likely to have a non-fatal cardiovascular event before the age of 60.

 “This is compared to women who reach menopause between the ages of 50 or 51, during what is considered the standard developmental period.”

Previous studies had already found a link between early menopause and fatal cardiovascular events. However, until now, the association with non-fatal cardiovascular events was uncertain.

 “Smoking, being overweight or obese, and having lower education levels can also strengthen the link between early menopause and a woman’s risk of cardiovascular disease,” stated Professor Mishra.

 Leader of the study, PhD scholar Dongshan Zhu, commented that the study has important clinical and public health implications.

Mr Zhu noted: “Identifying women with early menopause offers a window of opportunity for their doctors to work with them to monitor and actively manage cardiovascular disease risk factors.

“Early clinical diagnosis will help to improve overall cardiovascular health in their postmenopausal years.”

Commentary

What is menopause?

Menopause is the time that marks the end of menstrual cycles for women, signifying the end of natural reproductive life. It is a gradual process that it is usually diagnosed when a woman has gone 12 months without having a period. Typically, menopause occurs around the age of 50, however it can happen anytime during the 40s or 50s.1,2

 Most women – around 8 out of 10 – experience some symptoms around the time of menopause. This includes symptoms such as irregular periods (up until the last period), vaginal dryness, problems with sleep, mood changes, hot flushes, chills, night sweats, weight gain, thinning of the hair, dry skin and breast changes.1,2 One out of 10 women continue to experience symptoms up to 12 years after their last period.2

 It is important to note that during the stage of irregular periods, pregnancy is still possible.1   

 What does this study mean for addressing sex-bias in health care?

 A common fallacy that exists among health professionals, as well as the general public, is that cardiovascular disease mainly affects men (at least until older age). Moreover, most algorithms that health professionals use to calculate cardiovascular disease risk for their patients, do not adequately take into account gender-specific differences.3

 What is the Framingham Risk Score and how is it used to calculate risk of cardiovascular disease?

 This gender-bias must be addressed. Research that attempts to reveal important sex-specific risk factors, such as early menopause, provide a vital opportunity for identifying women at increased risk of cardiovascular disease.3 

References

1.     Mayo clinic (online). Menopause [accessed 2 Dec 2019]. Available from: URL link
2.     NICE guideline (online). Menopause: diagnosis and management. Draft for consultation, June 2015 [accessed 2 Dec 2019]. Available from: URL link
3.     Bernhardt, Lizelle and Lawson, Claire, 2019. Early menopause and risk of cardiovascular disease: an issue for young women. The Lancet Public Health, 4(11), pp.e539-e540. Abstract available: URL link