Long-term health effects of early menopause

Early menopause (EM)/premature ovarian insufficiency (POI) leads to the early loss of oestrogen, which may negatively affect bone, cardiovascular, and cognitive health over the long term. Hormone replacement therapy (HRT) (also known as Menopause Hormone Therapy) and lifestyle changes can help reduce these risks; where possible, it is recommended that HRT is continued until the usual age of menopause (about 51 years) (see Lifestyle changes to help manage early menopause).

Long-term effects of early menopause: Women’s knowledge and information sources

All the women we spoke with knew that EM could increase their risk of osteoporosis, while around half mentioned increased risk of heart disease. A couple were aware dementia was a potential risk; however, the medical evidence about this is less certain.

Debra shared her knowledge of the long-term risks of early menopause. 

A few women said that a lack of knowledge about the full spectrum of long-term health risks could feel unsettling. As Jenni said: ‘I feel incredibly naïve (…) I don’t know what the health implications are for me long-term.’

Women mainly learned about the long-term health effects of EM from health practitioners, their own reading, or both. Some described their doctors as very informative and focussed on lowering their long-term health risks. Maddy commented: ‘[My doctor] was more concerned about health problems, not just about the symptoms. It was, “You’re 40, you are too young not to have oestrogen and progesterone protecting you”’. In contrast, others felt their doctors could have provided more information.

Linda felt her doctors had ‘not been proactive’ in relation to the long-term risks of early menopause. 

Some women learned about the long-term health effects of EM through participating in research studies or attending information sessions run by health services.

Ella described realising ‘how involved’ early menopause was at a talk she attended at another health service.

Management and monitoring: Knowledge and experiences

Most women knew Hormone Replacement Therapy (HRT) had a protective effect on bone density. However, not all were able to have this treatment, because they had experienced hormone sensitive cancer, such as breast cancer, (see Non-hormone based medications for early menopause), or because they experienced side-effects they could not tolerate (see Taking hormone-based medications for early menopause).

Awareness of the importance of exercise and diet to bone and heart health was high among the women we interviewed, and many were taking calcium and Vitamin D supplements (see Lifestyle changes to help manage early menopause).

Melinda recounted her endocrinologist’s ‘holistic’ advice about looking after her bones.

Most women were actively monitoring their bone density via bone mineral density scans, though some more often than others. A couple had never had a bone density scan – Julia, whose GP had never mentioned it, and Natalie who said she was planning to make an appointment. Other tests and scans women mentioned included blood tests to check cholesterol levels and mammograms.

Sonia took responsibility for organising her own scans and tests after being diagnosed with spontaneous early menopause and a thyroid condition. 

Thoughts and feelings about long-term health impacts of early menopause

First learning about the long-term health impacts of early menopause was a distressing experience for many women, particularly if, like Melinda, they had already experienced some early symptoms: ‘[My osteopenia diagnosis] shocked me probably more than my menopause diagnosis’.

Lorena described how she felt when she learned about the risks to bone health as a result of experiencing early menopause at age 25.

Anxiety and uncertainty about future health, wellbeing, and premature ageing were expressed by many women (see Early menopause and identity, social connection and future plans). As Anna said: ‘I want to make sure my bone density is okay, because if I do happen to be able to live to a ripe age, I don’t want it to be restricted by my body not holding up’.

Anxiety about the future was particularly pronounced among women who experienced EM following cancer treatment, or who carried one of the BRCA gene mutations.

For Kirsty, finding out about the long-term impacts of early menopause was a ‘big process.’

A few post-menopausal women said they had reconciled with the long-term health effects of EM, and described learning to live with uncertainty about the future.

Fiona, who experienced early menopause after breast cancer treatment, said she now saw herself as starting the ‘mature, elderly, wise’ part of her life.

Further information:

Talking Points (Women)

Talking Points (Health Practitioners)

Other resources