Early Menopause Poses Health and Mortality Risks

Menopause before age 47 significantly increases the risk of osteoporosis, fragility fractures, and premature mortality over the next 30 years, according to a new study.

Researchers at Skåne University Hospital (Malmö, Sweden) conducted a prospective population-based observational study involving 390 white north European women aged 48 recruited in 1977 for the Malmo perimenopausal study. The women were divided into two categories; women who started menopause before age 47 and women who started the menopause at age 47 or later. An initial bone mineral density (BMD) was measured, and at the age of 77, all eligible women were re-measured for BMD. The prevalence of osteoporosis was determined using dual-energy X-ray absorptiometry (DXA).

The results showed that at age 77, 298 women were still alive, while 92 had died; of these, 100 had relocated or declined further participation, leaving 198 women to attend the follow-up measurement. In all, 56% of women with early menopause had osteoporosis, in comparison with 30% of women with late menopause. Women who started the menopause early were also found to have a higher risk of mortality (52.4%), compared to 35.2% in the late menopause group. The fragility fracture incidence rate was also higher--44.3% in the early menopause group compared to 30.7% in the late menopause group. The study was published early online on April 25, 2012, in BJOG.

“The results of this study suggest that early menopause is a significant risk factor for osteoporosis, fragility fracture, and mortality in a long-term perspective,” concluded lead author orthopedic surgeon Ola Svejme, MD, and colleagues. “The higher fracture risk in women with early menopause in the current study is probably to some extent mediated by a lower bone mineral density, as the early-menopause cohort had a significantly higher risk of osteoporosis at age 77. To our knowledge, this is the first prospective study with a follow-up period of more than three decades.”

Menopause is a term used to describe the permanent cessation of the primary functions of the human ovaries, including estradiol and progesterone production, part of the female body's endocrine system of hormone production. After menopause, estrogen continues to be produced in other tissues, notably the ovaries, but also in bone, blood vessels and even in the brain; but the dramatic fall in circulating estradiol levels at menopause impacts many tissues, from bone to brain to skin.

Related Links:
Skåne University Hospital