Long-term Finnish study examines link between premature menopause and mortality

Women who reach menopause before age 40 are more likely to die young but can reduce their risk with hormone therapy, according to research presented at the 26th European Congress of Endocrinology in Stockholm. This long-term Finnish study is the largest yet conducted on the association between premature menopause and mortality, highlighting the importance of regular medical examinations and appropriate use of hormone therapy in these women.

Most women experience menopause between the ages of 45 and 55. However, about 1% of women experience menopause before age 40, which is known as premature menopause or premature ovarian failure (POI), and they are at higher risk of long-term health problems such as like heart disease. The causes are largely unknown, but can occur spontaneously or as a result of certain medical procedures such as chemotherapy or surgical removal of the ovaries. Hormone replacement therapy (HRT) is the most common treatment, but most women with premature menopause do not take these medications as recommended.

In this study, researchers from the University of Oulu and Oulu University Hospital examined 5,817 women who were diagnosed with spontaneous or surgical premature ovarian failure in Finland between 1988 and 2017. They compared these women with 22,859 women without POI and found that women with spontaneous premature ovarian failure were more than twice as likely to die from any cause or from heart disease, and more than four times as likely to die from cancer. However, the risk of death from all causes and cancer was approximately halved in women who used hormone replacement therapy for more than six months. Women with surgically induced premature menopause had no additional risk of mortality.

Previous studies have also shown that women with premature menopause have a higher risk of early death. However, such an association has never before been studied in women on such a large scale and with such a long follow-up period of up to 30 years. "To our knowledge, this is the largest study conducted on the relationship between premature ovarian failure and mortality risk," said Miss Hilla Haapakoski, a graduate student at the University of Oulu who led the study.

"Our study is one of the first to examine both surgical and spontaneous premature ovarian failure in women for all-cause cardiovascular and cancer-related mortality, and examines whether hormone replacement therapy for more than six months can reduce the risk "Our results suggest that special attention should be paid to the health of women with spontaneous premature ovarian failure to reduce excess mortality." - said Ms Hilla Haapakoski, PhD student at the University of Oulu.

The team will further evaluate how women with premature menopause are at risk for other diseases or conditions, such as cancer or heart disease, and whether long-term use of hormone therapy affects these conditions. "The various health risks for women with premature ovarian failure have not yet been properly recognized, and the use of hormone replacement therapy (HRT) is often ignored. We hope to improve the health of these women by increasing awareness of the risks among health professionals and women themselves," said Ms Haapakoski.