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Premature menopause may increase the risk of death from cardiovascular disease and cancer
Last reviewed: 02.07.2025
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Women who experience menopause before age 40 are more likely to die at a younger age, according to a study from Finland presented at the 26th European Congress of Endocrinology.
Experts note that this increased mortality risk also applies to women who have experienced premature menopause.
"This study confirms what we already know and believe in the gynecological profession," said Dr. Vanessa Soviero, an obstetrician-gynecologist at the Katz Institute for Women's Health at Northwell Health, who was not involved in the study.
Soviero emphasized the need for more research into women’s health, a historically understudied area. Although only 1% of women experience premature menopause, also known as primary ovarian insufficiency (POI), Soviero noted that the research is applicable to other women.
"It's not just women who have had early menopause," Soviero said. "Women who have had their ovaries removed at a young age also face these risks."
A woman may need to have one or both ovaries removed for reasons such as endometriosis and benign tumors (cysts), or if she is at significant risk of breast or ovarian cancer and is having prophylactic surgery.
Premature Menopause Study Details
Researchers from the University of Oulu and Oulu University Hospital in Finland studied nearly 5,800 women who were diagnosed with spontaneous or surgically induced MOF between 1988 and 2017.
They compared the results with nearly 23,000 women without PON.
Their findings, which have not yet been published in a peer-reviewed journal, were that women with MODS were twice as likely to die from cardiovascular disease and four times as likely to die from any type of cancer. They were also listed as twice as likely to die from any cause.
There was no significant difference in the risk of death in women with naturally occurring MOD compared with surgically induced MOD.
While previous studies have focused on the link between premature menopause and a woman's risk of death, this study is the largest to date. It is also the first to include surgically induced menopause.
“To our knowledge, this is the largest study conducted on the association between primary ovarian insufficiency and mortality risk,” explained Hilla Haapakoski, lead author of the study and a PhD student at the University of Oulu, in a press release.
While past research has highlighted the link between menopause and heart health—regardless of a woman's age—menopause before age 40 carries significantly greater risks.
"The risks are highest in women who go through menopause before age 40, but every woman should consider taking hormones even before menopause," Soviero said.
“I encourage women to start [hormone replacement therapy] before they enter menopause, when perimenopausal symptoms begin to develop,” Soviero said. “The earlier you start hormone therapy, the more cardiac, cognitive, and bone benefits you’ll get.”
Hormone Replacement Therapy and Premature Menopause
“In our practice, we recommend birth control pills to anyone who has POF or has had their ovaries removed because it reduces all the risks associated with low estrogen levels,” Soviero explained.
In their study, the researchers reported that women who used hormone replacement therapy for at least six months were half as likely to die from cancer or other causes.
“Women can reduce their risk with birth control, but many women think they don’t need birth control during menopause because they can’t get pregnant,” Soviero said. “Hormone therapy will reduce your risk of heart attack and stroke, but it will also reduce your risk of cognitive disorders like dementia and Alzheimer’s, as well as osteoporosis and fractures.”
Soviero said she educates her patients to combat common misconceptions about birth control, hormones and HRT.
"Most people don't understand the benefits of hormones, especially estrogen," Soviero said. "And they've seen information on social media that's not accurate for most women. Estrogen and progesterone should both be considered."
After menopause, estrogen protects the heart, brain and bone health, Soviero said. Progesterone protects the uterus.
Women who should not consider hormone therapy include anyone with a history of breast cancer, uterine cancer, or bleeding disorders.
While there are some risks associated with hormone replacement therapy, Soviero said the benefits of HRT outweigh the risks.
The researchers said their next steps would be to evaluate the long-term effects of hormone therapy.
“The various health risks of women with primary ovarian insufficiency are not well recognized, and the use of [hormone replacement therapy] is often ignored,” Haapakoski said. “We hope to improve the health of these women by raising awareness of the risks among health care providers and the women themselves.”