Takeaways
- Women who experience early natural menopause (≤40 years) have a 27% higher relative risk of developing metabolic syndrome compared with those with later menopause (≥50 years).
- The association between age at natural menopause and metabolic syndrome remained significant even after adjusting for confounding factors such as race, body mass index, and medication use.
- Researchers emphasize that early menopause should be viewed as a cardiometabolic risk marker, underscoring the need for earlier screening and preventive interventions to reduce long-term heart and metabolic disease risk.
The transition through menopause marks a critical period in women’s cardiometabolic health. A new large-scale study presented at The Menopause Society’s 2025 Annual Meeting in Orlando found that women who experience natural menopause at an earlier age face a significantly higher risk of developing metabolic syndrome than those whose menopause occurs later.1,2
Background on metabolic syndrome
Metabolic syndrome represents a constellation of interrelated risk factors—including obesity, high blood pressure, elevated fasting glucose, and dyslipidemia—that collectively raise the likelihood of cardiovascular disease, stroke, and type 2 diabetes. It can accelerate atherosclerotic plaque buildup and contribute to vascular complications and certain cancers.
As estrogen levels decline during menopause, the protective metabolic effects of the hormone diminish, predisposing women to these cardiometabolic disturbances. “The prevalence of metabolic syndrome, a dangerous and potentially deadly condition, increases with menopause,” the press release noted.
Study design and methods
The study, titled “Prevalence and Risk Factors of Metabolic Syndrome in Women with Natural Menopause,” analyzed longitudinal data from more than 234,000 women who experienced natural menopause between the ages of 30 and 60 years. Participants were drawn from the All of Us Research Program and excluded those whose menopause was induced by hysterectomy, bilateral oophorectomy, radiation, chemotherapy, or hormone therapy use.
Researchers used electronic health record data to identify metabolic syndrome based on the National Cholesterol Education Program criteria, which include triglyceride levels ≥150 mg/dL, high-density lipoprotein ≤50 mg/dL, and glucose ≥110 mg/dL. Women were categorized as having early menopause (≤40 years) or late menopause (≥50 years). Six logistic regression models were constructed to assess associations between age at menopause and metabolic syndrome, adjusting for potential confounders such as race, body mass index, and use of cardiovascular or diabetes medications.
Key findings
Among the cohort, the overall prevalence of metabolic syndrome was 11.7%, with 13.5% in women with early menopause compared with 10.8% in those with late menopause. Statistical modeling revealed a 27% increased relative risk of metabolic syndrome for women experiencing early menopause (relative risk, 1.27; 95% CI, 1.05-1.53; P = .014). These associations remained significant after adjustment for confounders in the most comprehensive model (β = –3.236; 95% CI, –3.9224 to –2.5496).
Clinical interpretation
“Our findings show that age at natural menopause isn’t just a reproductive milestone—it’s a powerful indication of long-term cardiometabolic risk,” said Shefali Setia Verma, PhD, one of the study’s authors from the University of Pennsylvania. “Recognizing early menopause as a marker for metabolic syndrome gives clinicians a crucial window to identify at-risk women sooner and intervene earlier to prevent heart disease, diabetes, and other complications.”
The investigators emphasized that early identification of women at risk could improve long-term outcomes through targeted lifestyle interventions, glucose and lipid monitoring, and timely pharmacologic management where appropriate.
Broader implications
The study underscores the potential role of menopausal age as a clinical biomarker for cardiometabolic risk stratification in postmenopausal women. By integrating age at natural menopause into cardiovascular risk assessments, clinicians may enhance preventive strategies for women entering menopause earlier than average.
“This is yet another example of how premature and early menopause are linked with increased risk for adverse health outcomes,” said Stephanie Faubion, MD, MBA, medical director for The Menopause Society. “The more we can understand these potential risks, the better our ability to intervene early in order to offset these risks.”
Conclusion
These findings provide compelling evidence that early natural menopause is independently associated with an increased prevalence of metabolic syndrome, even after accounting for race, body mass index, and medication use. The results highlight the importance of screening for metabolic syndrome components in women with early menopause and support early clinical intervention to mitigate long-term cardiovascular and metabolic consequences.
References
- The Menopause Society. Early Natural Menopause Linked with Higher Risk of Metabolic Syndrome. Press release. October 21, 2025. Accessed October 21, 2025.
- Mohammed S, Cherlin T, Verma SS. Prevalence and Risk Factors of Metabolic Syndrome in Women with Natural Menopause. Abstract. Presented at: The Menopause Society’s 2025 Annual Meeting. October 21–25, 2025. Orlando, Florida.
