Menopause Before 45 Increases Your Risk of Diabetes

Patient Expert

Did you go through menopause before the age of 45? Researchers think that you might be at a higher risk of type 2 diabetes.

These findings were reported at the 2018 meeting of the European Association for the Study of Diabetes (EASD). The research found that, compared to menopause after age 45:

  • Premature menopause before age 40 makes you 50 percent more likely to develop type 2 diabetes.
  • Early menopause between 40 and 45 makes you 15 percent more likely to develop type 2 diabetes.

Before we delve into this finding, let’s take a closer look at premature and early menopause.

Understanding menopause

Menopause is diagnosed after it’s been a full year since your last menstrual period. Menopause typically occurs after age 45, but the average age is 51.

Premature menopause is sometimes called premature ovarian failure, or POF. Premature menopause affects around 1 percent of women under 40.

Early menopause affects around 5 percent of women  between the ages of 40 and 45.

Causes of premature and early menopause

Menopause falls into two categories: spontaneous or induced.

The causes of spontaneous menopause include normal aging, family history, and autoimmunity. Genetic disorders such as Turner syndrome or Fragile X syndrome can trigger menopause before 45.

The causes of induced menopause include chemotherapy and radiation treatment for cancer. Surgery to remove the ovaries (oophorectomy) or uterus (hysterectomy) can also cause menopause.

You are at higher risk for premature or early menopause if:

  • You have been treated with chemotherapy or radiation
  • You have a personal or family history of autoimmune disease
  • Your mother or sister experienced premature or early menopause
  • You unsuccessfully tried to become pregnant for more than a year

Symptoms of premature or early menopause

The symptoms of premature or early menopause include:

  • Irregular or missed menstrual periods
  • Heavier or lighter periods
  • Infertility
  • Hot flashes
  • Night sweats
  • Vaginal dryness
  • Moodiness, anxiety, mild depression
  • Insomnia and sleep problems
  • Brain fog, difficulty concentrating
  • Decreased sex drive
  • An irritable bladder
  • More frequent urinary tract infections
  • Urinary incontinence

How are premature and early menopause diagnosed?

Menopause can be diagnosed with:

  • A thorough medical history.
  • Review of your menstrual cycle.
  • A physical exam, and specifically, a pelvic exam.
  • An estradiol test: This form of estrogen drops significantly in menopause.
  • A follicle-stimulating hormone (FSH) test: This hormone becomes elevated during menopause.

If you want to conceive, you may also be tested for:

  • Anti-Müllerian Hormone (AMH). AMH is produced by ovarian follicles. The higher this hormone level, the more eggs and follicles are still present.
  • Antral Follicle Count, by Ultrasound - This test estimates your number of immature eggs. The lower the number, the fewer eggs in reserve.

Complications of early and premature menopause

In addition to type 2 diabetes, early and premature menopause can increase your chance of developing other conditions including:

  • Infertility
  • Bone loss (osteoporosis), due to low estrogen levels
  • Stress, anxiety, and depression

Treating premature and early menopause

Premature or early menopause doesn’t mean you can’t become pregnant. It can, however, make it harder. If you want to conceive, it’s important to see a fertility specialist to explore your treatment options.

Some experts recommend that all women with premature and early menopause be treated with hormone replacement therapy (HRT) until around age 51.

HRT treatment typically includes estrogen and progesterone. HRT comes in many forms: pills, injection, patch, transdermal cream, or pellets inserted under the skin.

The rationale is that HRT may reduce the health risks of prolonged estrogen deficiency like reduced bone density. HRT also helps relieve troublesome menopausal symptoms.

HRT is controversial, however, and is not recommended for all women due to the increased risk of heart problems, blood clots, stroke, and breast cancer.

The link between premature/early menopause and type 2 diabetes

Researchers don’t understand exactly why premature or early menopause increases your risk for type 2 diabetes. Experts do recommend, however, that if you go through menopause before age 45, you should do what you can to reduce your type 2 diabetes risk factors.

Specifically, to help reduce your risk of developing type 2 diabetes, you should:

  • Maintain a healthy weight
  • Regularly monitor your blood sugar
  • Maintain a healthy blood pressure
  • Eat a healthy, carbohydrate-controlled diet
  • Get regular exercise
  • Get enough sleep
  • Manage your stress

You can also keep up on new information about reducing your type 2 diabetes risk, such as the benefits of intermittent fasting, the role of dairy products, and maintaining healthy melatonin levels.

There is some evidence that HRT may help reduce the risk of type 2 diabetes after menopause, and help with better control of blood sugar levels. More studies are needed, however, before HRT is recommended to help prevent type 2 diabetes in women with premature or early menopause.

See more helpful articles:

Are You at Risk for Type 2 Diabetes?


Early Menopause, Shorter Life?