Early Menopause Linked to Higher Stroke Risk

Women who enter menopause early or who don’t use hormone replacement therapy may be at increased risk of stroke, according to a study.

Those with longer reproductive lives and who used contraceptives or HRT had fewer strokes in their mid-60s.

The experts said the findings suggest that those who start menopause early should be offered more regular blood pressure and cholesterol checks.

The researchers used data from nearly 123,000 postmenopausal women, with an average age of 58 years.

They were asked about their lifestyle, as well as information about reproductive health, such as age of first menstruation and onset of menopause, number of pregnancies and miscarriages, and use of oral contraceptives.

The researchers then used data from health insurance and disease registries to determine which participants had a stroke in the following decade.

Some, 15,139 suffered a stroke, 12,853 had an ischemic stroke, where blood flow to the brain is blocked, and 2,580 an intracerebral hemorrhage (bleeding in the brain) and 269 had a subarachnoid hemorrhage, bleeding between the brain and the membrane that covers it.

They were then divided into four groups determined by their reproductive lives, the number of years from their first menstruation to menopause.

Those with the shortest reproductive lives had up to 31 reproductive years compared to 36 years or more in the longest group.

When the researchers adjusted for other factors that could affect stroke risk, such as age, smoking, physical activity and high blood pressure, they found that participants in the longest group had a 5 percent lower risk than all types of stroke.

This increased to 13 percent with intracerebral hemorrhage compared with the lowest group, according to the findings published in the journal Neurology.

The researchers also looked at other factors that affect estrogen levels, such as multiple births and use of oral contraceptives, both of which are associated with higher levels.

They found that higher estrogen levels led to a lower risk of all types of stroke, as well as ischemic stroke and intracerebral hemorrhage.

Lead author Peige Song, from Zhejiang University School of Medicine in Hangzhou, China, said the findings show that lifetime estrogen exposure could be a useful indicator of a person’s stroke risk. person after menopause.

She said: ‘Our study suggests that higher estrogen levels due to a number of reproductive factors, including longer reproductive life and the use of hormone therapy or contraception, are linked to a lower risk of ischemic stroke and intracerebral hemorrhage. .

“These findings could help with new ideas for stroke prevention, such as considering screening for people who have brief lifetime exposure to estrogen.”