Premature menopause is associated with increased risk of heart problems

Menopause before 40 years of age is associated with elevated risks of heart failure and atrial fibrillation, according to a study published today in European Heart Journal, a journal of the European Society of Cardiology (ESC).1 The study in more than 1.4 million women found that the younger the age at menopause, the higher the risk of new-onset heart failure and atrial fibrillation.“Women with premature menopause should be aware that they may be more likely to develop heart failure or atrial fibrillation than their peers,” said study author Dr. Ga Eun Nam of Korea University College of Medicine, Seoul, Republic of Korea. “This may be good motivation to improve lifestyle habits known to be linked with heart disease, such as quitting smoking and exercising.” Cardiovascular disease typically occurs up to 10 years later in women than men.2 Premenopausal women are thought to benefit from oestrogen’s protective effect on the cardiovascular system. The cessation of menses and subsequent decline of oestrogen levels may make women more vulnerable to cardiovascular disease.Premature menopause affects 1% of women under the age of 40 years.3 Prior studies have found a link between premature (before age 40) and early (before age 45) menopause and cardiovascular disease overall, but the evidence for heart failure or atrial fibrillation alone is limited. This study examined the associations between premature menopause, age at menopause, and incident heart failure and atrial fibrillation. Data were obtained from the Korean National Health Insurance System (NHIS), which provides health screening at least every two years and includes 97% of the population.The study included 1,401,175 postmenopausal women aged 30 years and older who completed the NHIS health check-up in 2009. Participants were followed up until the end of 2018 for new-onset heart failure and atrial fibrillation. Information was collected on demographics, health behaviours and reproductive factors including age at menopause and use of hormone replacement therapy (HRT). Age at menopause was categorised as below 40, 40 to 44, 45 to 49, and 50 years or older. Premature menopause was defined as having the final menstrual period before the age of 40 years.Some 28,111 (2%) participants had a history of premature menopause. In these women, the average age at menopause was 36.7 years. The average age at study enrolment for women with and without a history of premature menopause was 60 and 61.5 years, respectively. During an average follow up of 9.1 years, 42,699 (3.0%) developed heart failure and 44,834 (3.2%) developed atrial fibrillation. The researchers analysed the association between history of premature menopause and incident heart failure and atrial fibrillation after adjusting for age, smoking, alcohol, physical activity, income, body mass index, hypertension, type 2 diabetes, dyslipidaemia, chronic kidney disease, coronary heart disease, HRT, and age at menarche. Women who experienced premature menopause had a 33% higher risk of heart failure 9% higher risk of atrial fibrillation compared to those who did not.The researchers then analysed the associations between age at menopause and incidence of heart failure and atrial fibrillation after adjusting for the same factors as in the previous analyses. The risk of incident heart failure increased as the age at menopause decreased. Compared with women aged 50 years and above at menopause, those aged 45 to 49, 40 to 44, and below 40 years at menopause had 11%, 23%, and 39% greater risks of incident heart failure, respectively. Similarly, the risk of incident atrial fibrillation increased as the age at menopause decreased, with 4%, 10%, and 11% higher risks for those aged 45 to 49, 40 to 44, and under 40 years at menopause, respectively, compared with women aged 50 years and above at menopause.The authors said that several factors may explain the associations between menopausal age, heart failure and atrial fibrillation, such as the drop in oestrogen level and changes in body fat distribution.

Nightshift work lowers age at menopause

The Nurses’ Health Study project has over past decades generated an enormous number of publications on an array of medical issues. This project has contributed importantly to our understanding of and discussion about female health, mostly in the context of reproductive science. Stock et al now extracted from this invaluable and ever-growing dataset that women exposed to occupational rotation/nightshift are at a slightly increased risk of accelerated menopausal onset. Menopause in the human is traditionally attributed to ovarian depletion of viable follicles. The study controlled for a number of potential confounders such as age, smoking and parity – each of which may influence or be related to ovarian reserve. To what extent bio-rhythmic disturbance may act in a similar way is an intriguing issue yet to be solved. Perhaps in the human, timing of final ovarian activity may depend to some extent on altered neuroendocrine activity as is the case in most other species. Nils Lambalk, Editor-in-Chief Human Reproduction

Women About Symptoms, Hormones and Latest Treatments for Menopause

As approximately one third of a woman’s life is spent post-menopause, doctors from Yale University hosted Yale’s “One-Day Medical School: Everything You Always Wanted to Know About Menopause but Were Too Afraid to Ask” event on October 25, 2018 to provide essential health education for women 45+.“Public health and medicine improvements over the past 150 years have increased the life expectancy of women into their late 80s. While the age of menopause onset has not changed, the transition to menopause has larger implications as it relates to sexuality and overall heath, both physiological and psychological,” says Mary Jane Minkin, MD, Clinical Professor of Obstetrics & Gynecology at Yale University. “It’s important for women to recognize the early signs of menopause and learn how to cope with hot flashes, changes in sleep quality, joint and muscle health, sexual functioning, and hindrances to comfort in everyday life.” Live stream available at: https://www.faboverfifty.com/events/day-medical-school/

European Society Human Reproduction and Embryology

Rome 28/6/2010 26th annual meeting of the European Society of Human Reproduction and Embryology. Dr Fahimeh Ramezani Tehrani will tell the in that her findings have implications for women and their doctors; if the results of the research are supported by larger studies, it means that women will be able to discover early on in their reproductive life what their expected age at menopause will be, so that they can plan when to start a family. By taking blood samples from 266 women, aged 20-49, who had been enrolled in the much larger Tehran Lipid and Glucose Study, Dr Ramezani Tehrani and her colleagues were able to measure the concentrations of a hormone that is produced by cells in women’s ovaries – anti-Mullerian Hormone (AMH). AMH controls the development of follicles in the ovaries, from which oocytes (eggs) develop and it has been suggested that AMH could be used for measuring ovarian function. The researchers took two further blood samples at three yearly intervals, and they also collected information on the women’s socioeconomic background and reproductive history. In addition, the women had physical examinations every three years. The Tehran Lipid and Glucose Study is a prospective study that started in 1998 and is still continuing.
Dr Ramezani Tehrani, who is President of the Reproductive Endocrinology Department of the Endocrine Research Centre and a faculty member and Associate Professor of Shahid Beheshti University of Medical Sciences in Tehran, Iran, said: “We developed a statistical model for estimating the age at menopause from a single measurement of AMH concentration in serum from blood samples.  Dr Ramezani Tehrani was able to use the statistical model to identify AMH levels at different ages that would predict if women were likely to have an early menopause (before the age of 45). She found that, for instance, AMH levels of 4.1 ng/ml or less predicted early menopause in 20-year-olds, AMH levels of 3.3 ng/ml predicted it in 25-year-olds, and AMH levels of 2.4 ng/ml predicted it in 30-year-olds.