Smoking, Obesity May Promote Early Menopause
Women with more risk factors for cardiovascular disease tend to enter menopause earlier
Women with more risk factors for cardiovascular disease tend to enter menopause earlier than women without heart disease risk factors, such as smoking, obesity, and high cholesterol, according to Framingham Heart Study.
If so, "this offers a novel explanation for the inconsistent findings on cardiovascular disease rate and its relationship to menopausal age and effects of hormone replacement therapy," Dr. Yvonne T. van der Schouw in the Netherlands suggests in the report.
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When the women were assessed at age 43, smoking was associated with a mean of 1.6 years earlier menopause onset. Similarly, each 20 mg/dL increased in premenopausal cholesterol level was associated with a 0.14-year earlier onset of menopause.
Women with increasing levels of cholesterol or systolic or diastolic blood pressure also had a younger age at menopause onset, whereas those with decreasing levels of cholesterol and/or blood pressure entered menopause at an older age.
Women who either gained or lost weight during the premenopausal period had a significantly earlier age of onset.
When the Framingham risk score was determined at age 35 for 248 women, those with a 1% higher 10-year risk of coronary heart disease had a significantly lower age of menopause.
Dr. van der Schouw's team notes that, while their data indicate that premenopausal risk factors for heart disease may be determinants of age at menopause, the converse may also be true -- that early menopause with its decreased estrogen levels increases the risk of heart disease.
They propose that the link between heart disease risk and age at menopause may be mediated by the effects of heart disease risk factors on the endocrine system, or that ischemic damage to highly vascularized ovaries due to atherosclerosis could induce early menopause.
In a related editorial, Dr. Vera Bittner, in Birmingham, Alabama, points out that the average age of menopause onset is similar in countries around the globe, whereas heart disease risk factors vary widely. This suggests that "the effect of heart disease risk factors on menopausal age is at most modest."
SOURCE: Reuters Health
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