Early Menopause Linked to Premature Death

People who stop menstruating earlier in life may have a higher risk of dying young, new research has found.

Specifically, those who hit menopause before the age of 40—known as premature menopause or premature ovarian insufficiency (POI)—are twice as likely to die of any cause.

People with POI are also more than four times more likely to die from cancer, according to the study, which is due to be presented by the researchers at the European Congress of Endocrinology at the Stockholm International Fairs (Stockholmsmässan) in Stockholm, Sweden from May 11 to 14.

Menopause is a natural biological process that marks the end of a woman’s menstrual cycles and reproductive years, triggered by the reduction in the production of hormones like estrogen and progesterone by the ovaries. Common symptoms include hot flashes, night sweats, mood changes, sleep problems, vaginal dryness and decreased libido, but the intensity and duration of symptoms vary widely among women.

The majority of people who experience menstruation undergo menopause between around ages 45 to 55, with only about 1 percent seeing menopause before age 40.

Researchers aren’t entirely sure what causes POI to occur spontaneously in some people, but surgery to remove the ovaries or certain chemotherapies can trigger the condition. Hormone replacement therapy (HRT) can help alleviate POI or delay its onset, but many people with POI don’t take HRT as they should, according to the researchers.

In the new study, the researchers from the University of Oulu and Oulu University Hospital analyzed data from nearly 6,000 Finnish women with POI between 1988 and 2017 and compared them to more than 22,000 women without the condition. They found that people with spontaneously developed POI were twice as likely to die young from heart disease and any other reason. They were also four times more likely to die young of cancer. These effects were not seen in women who had surgically triggered POI.

“To our knowledge, this is the largest study performed on the linkage between premature ovarian insufficiency and mortality risk,” study co-author Hilla Haapakoski, a Ph.D. student at the University of Oulu in Finland, said in a statement.

The researchers also discovered that if women used HRT for more than six months, the mortality risks decreased by half.

Past research has found similar patterns of increased mortality risk in women with POI, but this study is the first to explore the trend on such a large scale and over such a long period of time.

“Our study is one of the first to explore both surgical and spontaneous premature ovarian insufficiency in women’s all-cause, cardiovascular and cancer-related mortality, and examine whether hormone replacement therapy for over six months may reduce mortality risk,” Haapakoski said. “Our findings suggest specific attention should be paid to the health of women with spontaneous premature ovarian insufficiency to decrease excess mortality.”

The researchers hope to further investigate whether women with POI are more likely to develop heart disease or cancer compared to women who don’t have POI, and how HRT comes into play.

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

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