Type 2 diabetes triples risk of early menopause, study showsBMJ 2013; 347 doi: http://dx.doi.org/10.1136/bmj.f7676 (Published 27 December 2013) Cite this as: BMJ 2013;347:f7676
Women under 45 with type 2 diabetes have three times the risk of early menopause as women without diabetes, a large Latin American study has found.1
The cross sectional study included 6079 women aged 40-59 years from 11 countries in Latin America. The researchers asked Hispanic women with normal health (able to carry out everyday activities) who were accompanying people consulting at large medical centres to complete the Menopause Rating Scale and the Goldberg Anxiety-Depression Scale.
Among women aged 40-44 years nearly a third (29.5%) of those with type 2 diabetes but only 13.2% of those without diabetes had experienced natural menopause. This meant that the risk of being postmenopausal in women aged 40-44 years was almost three times as high in those with diabetes than in those without diabetes (odds ratio 2.76 (95% confidence interval 1.32 to 5.67)).
Adjustment for confounding factors, including obesity and hypertension, did not change this increased risk of early menopause in younger women with type 2 diabetes. But this increased risk of early menopause with diabetes disappeared in women older than 44.
“This observation may lead us to consider that there is a subgroup of diabetic women in whom the metabolic disorders of disease accelerate reproductive ageing, and they will therefore experience an early menopause,” said the study’s lead author, Álvaro Monterrosa-Castro, of the University of Cartagena, Colombia.
The prevalence of diabetes in the entire study population was 6.7%. Diabetes was associated with being overweight or obese (odds ratio 1.47 (1.15 to 1.89)) and having a waist circumference of 88 cm or greater (odds ratio 1.32 (1.06 to 1.65)), in addition to arterial hypertension, hormonal therapy, and older age.
The authors noted that menopause has been associated with an increase in abdominal fat caused by depletion of ovarian function.
“Premature ovarian insufficiency can impair health and life expectancy if poorly managed,” said Nick Panay, a consultant gynaecologist at the Chelsea and Westminster Hospital, London, commenting on the findings. “This study reinforces the importance of early diagnosis to detect and treat associated conditions such as diabetes, thus optimising short and long term wellbeing.”
Cite this as: BMJ 2013;347:f7676