New Delhi: Women in low and middle-income countries are at a higher risk of premature menopause, and south Asian women are at an increased risk, compared with other ethnicities, heightening chances of cardiovascular events, according to an analysis of data from 26 countries published in The Lancet Obstetrics, Gynaecology, and Women’s Health journal.
Women in low and middle-income countries could be at a 53 per cent increased risk of a premature menopause, with half of them reaching menopause by age 47.5 years, compared with age 50.6 years in high-income countries, the study found.
When evaluated against European women, South Asian women had a 34 per cent increased risk of premature menopause, with half reaching menopause by age 47.4, compared with age 50.7 for European women, an international team of researchers, including those from The University of Sydney in Australia and institutes in Europe, Asia and Latin America, found.
Menopause is said to be premature if attained before turning 40 and early if attained during age 40-44.
Reaching menopause at a younger age is associated with an increased risk of a major cardiovascular disease event such as a heart attack or stroke — 14 per cent for early menopause and 27 per cent for premature menopause, the team found.
The link between premature menopause and a major heart-related event was consistent across across regions and ethnicities, the ‘Prospective Urban Rural Epidemiologic (PURE)’ study found.
Therefore, premature and early menopause could be independent and consistent markers of women with a higher cardiovascular risk, the researchers said.
“The findings highlight the importance of the management of cardiovascular risk for women with premature and early menopause globally,” the authors said.
Across the 26 countries analysed, 1,11,619 women were looked at of which 9.5 per cent were estimated to have had a premature menopause and 15.3 per cent to have had an early menopause.
“Women in low-income and middle-income countries (LMICs) had a 53 per cent increased risk of premature menopause, with half of them reaching menopause by age 47.5 years compared with 50.6 years in high-income countries,” the authors wrote.
“South Asian women had a 34 per cent increased risk compared with European women, with half of south Asian women reaching menopause by age 47.4 years compared with 50.7 years for European women,” they said.
The team added that the study is the largest asking two menopause questions — “Do you still have periods?” and “How many years since you stopped menstruating?” — consistently across 26 countries to understand trends in premature menopause and effects on cardiovascular events.
Higher cardiovascular events were noted in low and middle-income countries, compared to high-income countries, despite a lower prevalence of traditional risk factors, including high blood pressure, obesity and diabetes.
While risk factors also include air pollution, poor diet, low education and a low grip strength, the authors said that the woman-specific risk factor of early or premature menopause is an additional one for women in low-income countries.
“This study confirms the association of premature menopause and major cardiovascular events among women in one large internally consistent global study, and has found no heterogeneity in this association across country-income groups and major ethnic groups,” the authors said.
