Early Menopause Linked to Shorter Life and Diabetes

Menopause, T2DM, Life Expectancy. Type 2 diabetes mellitus (T2DM) often presents during midlife in women and recent evidence has linked age at menopause with T2DM and early menopause to early death. Few quantitative data exists on the combined association of early menopause and T2DM with LE. Authors sought to calculate and compare the association between age at natural menopause with total LE and number of years lived with or without T2DM.  

The Study. Authors utilized data from the Rotterdam Study, a population-based, prospective cohort of subjects aged ≥45 years. The study included 3650 women who were postmenopausal and experienced natural onset of menopause. Age at menopause was self-reported and T2DM cases were ascertained at baseline and during follow-up through clinical data. Age at menopause was defined as early (≤44 years), normal (45-54 years), and late (≥55 years). 

The Results. At baseline, 3240 women were T2DM-free and among them 305 developed incident T2DM, 489 died during follow-up, 164 died with T2DM, and early menopause was linked to increased mortality risk. The hazard ratio (HR) for mortality among women with T2DM experiencing early and normal menopause was 1.64 and 0.85, respectively (relative to late menopause). The difference in LE for the normal and early menopause vs the late menopause group was 1.3 and 4.6 years T2DM-free vs 0.8 and 1.1 years with T2DM.

Take Home Points. Women aged 50 years who experience early menopause are at risk for earlier death and more years living with T2DM vs those who experience normal or late menopause. While women who are T2DM-free at early menopause are still at increase risk for premature death, those who develop T2DM are at even higher risk. Encourage women to maintain normal weight while eating a diet aimed at preventing T2DM and develop individualized treatment plans based on menopause trajectory and risk factors to avoid early death and improve quality of life.