Early menopause link to increased mortality risk and fracture

Early menopause is associated with an increased risk of mortality and fracture later in life, researchers in Sweden have found.

Osteoporosis and fracture risk was raised among women who went through the menopause early (Photograph: SPL)
Osteoporosis and fracture risk was raised among women who went through the menopause early (Photograph: SPL)

Menopause before the age of 47 years was linked to a raised risk of mortality, fragility fractures and osteoporosis at the age of 77, the team from Skane University Hospital in Malmo, Sweden, found.

Dr Ola Svejme and colleagues examined the effects of early menopause in 390 women who had their forearm bone mineral density (BMD) measured at the age of 48.

When the women reached the age of 77, forearm BMD was re-assessed, along with proximal femur and lumbar spine BMD. Data on mortality rates and the incidence of fractures were collected until the women reached the age of 82.

Whether the women had gone through the menopause was noted at the start of the study, with menopause being defined as a minimum of 12 months of continuous amenorrhoea. The women were divided into early menopause (before age 47 years) and late menopause (at 47 years or later).

The women who went through the menopause before the age of 47 had a 83% higher risk of osteoporosis, a 68% higher risk of fragility fracture and a 59% higher mortality.

First prospective study
The researchers said that, although previous research had retrospectively linked early menopause with osteoporosis and fracture risk, this was the first prospective study to do so.

Dr Svejme and her team said: ‘The results of this population-based prospective observational study demonstrate that an early menopause is a significant risk factor for osteoporosis, fragility fracture and mortality.’

The researchers said the higher fracture risk among women with early menopause may be linked to low BMD.

‘However, the lower BMD level does not seem to be ent­irely able to explain the inc­reased fracture risk,’ they said.

‘We must therefore speculate as to whether factors beyond bone mass, such as inferior muscle strength or inferior neuromuscular function, ought to be found in women with early menopause.’

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