Premature menopause may cause changes linked to higher cardiovascular disease risk, finds study
Menopause not only mark the end of fertility in women but also causes huge hormonal fluctuations which affect the overall function of the body and mind.
Menopause is the natural cessation or stopping of a woman’s menstrual cycle. Not only does it mark the end of fertility in women but also causes huge hormonal fluctuations which affect the overall function of the body and mind. Just like menarche or the beginning of the menstrual cycle, menopause too has immense implications on a woman’s health and lifestyle.
Research suggests that usually, women experience perimenopause and menopause between the ages of 45 and 55 years. In some women — about 5 percent according to most experts — menopause can come a little early, which means between the ages of 40-45 years. However, in about 1 percent of cases, menopause can occur even earlier than that. Known as premature menopause, this abnormal phenomenon can occur before the age of 40 and is associated with many health risks.
Health risks of premature menopause
A study published in the journal Climacteric in 2015 suggests that this premature loss of ovarian function (also known as premature ovarian insufficiency or POI) can occur due to a number of reasons, including genetic disorders, autoimmune disorders, infections and a history of chemotherapy, radiation therapy or ovarian surgery. The study also suggests that going through premature menopause increases the long-term health risk of dementia, Parkinson’s disease, osteoporosis, mood disorders, sexual dysfunction, heart disease and early death.
A 2016 study in the Indian Journal of Medical Research says that women experiencing premature menopause have the highest risk of early mortality due to cardiovascular diseases but may also suffer immensely due to rapid bone mineral density loss. The latter not only increases their risk of fractures but can also lead to disability and loss of mobility. This study also suggests that women with symptoms of premature menopause must be screened properly so that genetic factors can be better understood and the risk of POI in their female offspring better managed.
Clonal hematopoiesis, menopause and heart disease
A new study published in Circulation further suggests that ageing is accelerated in women with premature menopause, which is one of the chief reasons why they have a higher risk of cardiovascular disease and associated mortality risks. Conducted by researchers at the Massachusetts General Hospital, the study is based on recent findings regarding clonal hematopoiesis.
According to a study published in the Annual Review of Pathology in early 2020, human ageing is associated with an increased frequency of mutations in the hematopoietic system (the system of organs and tissues involved in the production of blood, like bone marrow, spleen, tonsils and lymph nodes) which ultimately leads to the clonal expansion of these mutated cells. This process is known as clonal hematopoiesis and it can as per recent studies, lead to a higher risk of cardiovascular disease.
Since premature menopause involves rapid ageing, the Massachusetts researchers wondered if clonal hematopoiesis may be at play here too. To test their hypothesis, the researchers analysed blood samples from 11,495 postmenopausal women aged 40-70 years from the UK Biobank. They also collected samples from 8,111 postmenopausal women aged 50-79 years from the US Women’s Health Initiative. The team used DNA sequencing to trace the occurrence of clonal hematopoiesis among the participants.
Screening women for clonal hematopoiesis
Of these 19,606 women, 418 had natural premature menopause and 817 had premature menopause due to ovarian surgery. The researchers found that after a follow-up of 10 years for the UK participants and 13.1 years of follow-up for the US participants, there were 473 and 1,146 new cases of coronary artery disease respectively. The researchers were able to discover that premature menopause was associated with a 36 percent higher risk of clonal hematopoiesis and that this link was stronger among women with natural premature menopause.
The occurrence of clonal hematopoiesis was then correlated with a 36 percent higher risk of coronary artery disease (CAD). In certain cases, where the clonal hematopoiesis was at a higher range, the risk of CAD even went as high up as 48 percent. The researchers, therefore, concluded that not only was natural premature menopause linked with a high risk of CAD but also suggested that all women at risk of premature menopause should be regularly tested for clonal hematopoiesis to ascertain their risk of CAD and better management of said risk thereof.
For more information, read our article on Premature and early menopause.
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