What happens when you go into menopause early? Menopause is that time in a woman’s life when her ovaries stop working and produce no more hormones. Usually this is around 50 years old. However, now studies are showing that if you go through menopause in your late 30’s or early 40’s, you have an increased risk of cardiovascular disease if you don’t supplement your hormone levels.

A recent study in The Lancet Public Health looked at many different studies from all over the world that evaluated early menopause, also called premature menopause.[1] They pooled results from 15 different studies from Australia, Scandinavia, the USA, Japan, and the UK that were done between 1946 and 2013.

Overall, 301,438 women were included in the study. They split the women into three groups depending on their age when they went through menopause.

Premature Menopause and CVD Risk

What they found was that women who go through menopause prematurely was very significant. If they when through menopause at age < 40, their risk of developing cardiovascular disease compared to those going through menopause later (after age 50) increased 50%. Between 40-44, their risk increased around 30%, and 12% increased risk between ages 45 to 50. Of note, these women were not supplemented with hormones; they excluded anyone who had reported use of menopausal hormone therapy.

This is very significant since now women live around one-third of their life span after menopause. If you go through menopause prematurely, this length of time is even longer. This increased risk of CVD seen in early menopause had been seen in other studies and has been a concern.[2]

So why does this happen? It is thought that without natural hormones coming from your ovaries a women’s overall hormones are not balanced, including the ones from the adrenal glands and kidneys (the renin-angiotensin system). This results in changes to the inside linings of the blood vessels, called the endothelium. What is seen is dysfunction of this lining, with inflammation occurring resulting in vascular damage, similar to what one sees when someone has high blood pressure.

Since all your blood vessels would then be affected, the result would be changes seen in all your organs, including your brain and your bones. Indeed, one sees an increased risk of depression, dementia, and osteoporosis, in addition to the increase in CVD risk, when one goes into premature menopause.

What can be done to Decrease These Risks?

Obviously, you would want to do something about these unwanted changes so you would not get the endothelial damages seen with premature menopause. The most logical solution would be to make sure that the woman keeps her hormone balance intact since the main changes seen in premature menopause is that she has no more female hormones in her body.

These are estrogen, testosterone and progesterone. So, can we just supplement her with hormones and would this revert these CVD risks back to normal? The answer is absolutely YES! It is that easy.

In fact, one study performed at Mayo clinic confirmed this treatment. When women went into premature menopause, they saw 44% increased risks of CVD and stroke. However, if the women took hormones when they went through premature menopause and continued to take them, her risk of CVD and stroke decreased by 35%.[3]

 Conclusion

Thus, if you go through premature menopause, or even just normal menopause, don’t just let nature take its course for you could be setting yourself up for increased heart problems and strokes. Instead, be proactive and take hormone therapy, which will actually decrease your risks of developing these problems markedly.

References:

[1] Zhu D, et al. Age at natural menopause and risk of incident cardiovascular disease: a pooled analysis of individual patient data. October 03, 2019. DOI:https://doi.org/10.1016/S2468-2667(19)30155-0

[2] Muka T, Oliver-Williams C, Kunutsor S, et al. 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.JAMA Cardiol. 2016; 1: 767-776

[3]  Rivera CM, Grossardt BR, Rhodes DJ, et al. Increased cardiovascular mortality after early bilateral oophorectomy. Menopause. 2009;16:15–23.- Mayo