Can early menopause raise the risk of heart problems? Swedish experts weigh in.

September 9, 2022 Swedish Women's Health Team
[4 min read]
In this article: 
  • A new study found that women who go through menopause before the age of 40 are at a greater risk of heart problems. 
  • Women who go through early menopause should consider hormone replacement therapy until the age of natural menopause. 
  • Lifestyle choices, including exercise and a healthy diet, are central to cardiac health. 
A study released in August from the Korea University College of Medicine in Seoul reported that women who go through menopause when they are younger than 40 are at a greater risk of heart problems. The study’s findings appeared in the European Heart Journal.   
The study of more than 1.4 million females showed that women with premature menopause had a 33% higher risk of heart failure and a 9% higher risk of irregular heart rhythm, or atrial fibrillation, than those who experienced normal menopause. Researchers found that heart health risks increased as women experienced menopause earlier in life compared with those who went into menopause after the age of 50. According to the study: 
  • Risk of heart failure was 39% higher for women starting menopause younger than 40, compared with 11% higher for women starting menopause between the ages of 45 and 49. 
  • The risk of atrial fibrillation was 11% higher for women younger than 40, while it was 4% higher for women between the ages of 45 and 49. 
While the study highlights critical information about menopause, says Rebecca Dunsmoor-Su, M.D., Swedish’s Medical Director for Menopause and Director of Swedish’s Women’s Wellness and Specialties Center, there are standards of care that help protect women’s cardiac health throughout menopause and beyond. 
“I think this study brings to light important and not unexpected findings. We know that women’s heart disease increased after menopause, and that the earlier this menopause happens the higher their risk over their lifetime. I do not see in the reporting or in the paper the impact of menopausal hormone therapy (MHT) evaluated, which may be due to where the study was completed, as MHT may not be as commonly used in Korea where the study was done,” says Dr. Dunsmoor-Su. ”Women who go through menopause early should use hormone replacement therapy at least until the average age of natural menopause. This is the standard of care as it protects the cardiovascular system as well as the bones. Women who do this are not increasing their risks, as they are using a hormone that they would ‘normally’ have until this age. Seeing a provider with experience in the types of MHT and how to use them in younger women is important.”
Humera Ali, M.D., an interventional cardiologist at Swedish, emphasized the importance of patients and physicians understanding the full scope of cardiac risks and ways to prevent them. necessity of a healthy lifestyle in maintaining cardiac health. 
“This study highlights one of my most serious concerns, which is the under-appreciation by women and their physicians of the higher risk women have for heart failure disability due to the heart’s loss of efficiency as a pump and atrial fibrillation, a persistently irregular heartbeat rhythm, which can lead to disability and stroke,” says Dr. Ali. “The earlier the menopause, the higher the risk. Most risk calculators are used to predict the risk of a heart attack, and do not address the risk for heart failure or atrial fibrillation.”
Dr. Ali stresses a holistic and long-term approach to cardiac wellness for all patients, and particularly for those with increased risk factors. 
“Cardiac wellness throughout life is a lifestyle that we all must adopt into our daily lives. It involves the routines of daily aerobic exercise, choosing lower saturated fat and salt options in our meal choices, and knowing those hold even more importance due to the natural weight gain—about 10-15 pounds—the jump in bad cholesterol (LDL) that also occurs when we lose estrogen post menopause,” says Dr. Ali. “We must work harder at keeping our risk down after menopause than before.  Never taking up smoking and make sure you are getting regular checkups that can detect high blood pressure or high blood sugar; these should be considerations throughout life.”
“Cardiovascular disease is the biggest concern for women as they age. It kills more women than breast cancer,” stresses Dr. Dunsmoor-Su. “Be sure you are talking to a menopause-savvy doctor, paying attention to diet and exercise—knowing the signs of heart attack in women and getting appropriate screening are key. Also keep in mind that benefits of MHT outweigh the risks for many women. Please do not make decisions from a place of (misplaced) fear about hormones; talk to your provider and get the facts.” 
Learn more and find a provider

If you have concerns about contraception, pregnancy, menopause or any cancers, it’s important to see a gynecologist, women’s health provider or primary care doctor. If you are in need of an annual physical exam or have concerns about your heart and require an in-person visit or want to consult a doctor virtually, you have options.

Swedish Virtual Care connects you face-to-face with a nurse practitioner who can review your symptoms, provide instruction and follow up as needed. If you need to find a doctor, you can use our provider directory.

Join our Patient and Family Advisory Council.

Related resources

Women’s health: Changes for every phase of life

Heart Disease: What women need to know

This information is not intended as a substitute for professional medical care. Always follow your health care professional's instructions.

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About the Author

Whether you are seeking gynecological advice, need help navigating your way through the menopause stage of life or researching a recent breast cancer diagnosis, the Swedish Women's Health Team is committed to helping women find the information they need to live happy and healthy lives.

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