Early menopause raises risks of osteoporosis, fracture, death


Women who experience early menopause?before age 47?have increased risks for osteoporosis, fragility fractures, and death.

Early menopause is associated with substantially increased risks of osteoporosis, fractures, and death.

Lower bone mass density, which is common in those who experience early menopause, has been implicated as a cause of increased osteoporosis and fragility fracture in these women.

Compared with menopause occurring at or after age 47, early menopause-before age 47-almost doubles a woman’s risk of osteoporosis by age 77, increases her risk of fragility fracture by almost 70%, and increases her risk of death by almost 60%, according to the results of a population-based observational study from Sweden.

A total of 390 white northern European women who were 48 years old at the time the study began participated in the study. Published online April 25 in theBritish Journal of Obstetrics and Gynaecology, the results show that women who reach menopause before age 47 have risk ratios for osteoporosis at age 77, for fragility fracture, and for death of 1.83 (1.22-2.74), 1.68 (1.05-2.57), and 1.59 (1.04-2.36), respectively (all 95% confidence intervals).

The authors of the study believe the higher fracture and osteoporosis rates among women who experienced early menopause are associated with lower bone mass density (BMD); these women had on average a 0.4 standard deviation lower BMD than the women who experienced menopause later. But they do not believe that lower BMD provides the full explanation; other factors, such as inferior muscle strength or neuromuscular function, may be involved.

Similarly, they can only speculate about the association between early menopause and higher mortality, saying that although it could be the result of increased fracture-related mortality, it is probably also related to group differences in general diseases, medication, nutrition, smoking and alcohol habits, physical activity, and other lifestyle factors.

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raanan meyer, md
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