How premature menopause can cause premature death: new study

Health

By Tracy Swartz

Women who went through menopause before age 40 are four times more likely to die young from cancer – and twice as likely to die young from heart or other disease, according to a new Finnish study.

However, researchers say that using hormone replacement therapy (HRT) for more than six months can reduce the risk of all-cause mortality and the risk of cancer mortality by about half. They presented their results on Saturday at the 26th European Congress of Endocrinology in Stockholm.

“The various health risks for women with premature ovarian failure have not been well recognized and the use of HRT is often overlooked,” said Hilla Haapakoski, a doctoral student at the University of Oulu, who led the study.

“We hope to improve the health of these women by increasing awareness of the risks among health professionals and women themselves,” she added.

Menopause occurs when a woman’s ovaries stop releasing eggs: her body produces less estrogen and progesterone. This happens when she has gone 12 consecutive months without a period.

Although most women enter menopause naturally between the ages of 45 and 55, 1% of women experience premature menopause or premature ovarian insufficiency (POI) and go through menopause before age 40.

Genetic disorders, autoimmune diseases, chemotherapy, or surgery to remove the ovaries can lead to POI, but in many cases the exact cause is not obvious.

Researchers from the University of Oulu and Oulu University Hospital compared 5,817 Finnish women diagnosed with spontaneous or surgical POI between 1988 and 2017 with 22,859 women without the condition.

They calculated the risks of cancer and heart disease while noting that women with POI following surgery had no additional mortality risk.

Although other studies have linked premature menopause and early death, the Finnish team believes their research has the largest sample and covers the longest period, 30 years.

“To our knowledge, this is the largest study done on the link between premature ovarian failure and mortality risk,” Haapakoski said.

HRT is the most common treatment for POI – it replaces estrogen and other hormones that the ovaries no longer produce – but researchers say most women don’t follow recommendations for taking these medications.

The team plans to soon explore whether POI patients are more likely to suffer from cancer, heart disease or other illnesses – and whether HRT over a long period of time can affect these conditions.