Early menopause linked to increased STROKE risk

Women who go into early menopause or do not use hormone replacement therapy could be at higher risk of stroke, a study has found.

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

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

Researchers used data from almost 123,000 postmenopausal women, with an average age of 58.

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

Researchers then used health insurance and disease registry data to determine which participants had a stroke in the following decade.

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

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

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

When 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 of all kinds of stroke.

This rose to 13 percent with intracerebral hemorrhage when compared to the shortest group, according to the findings published in the Neurology journal.

Researchers also looked at other factors affecting estrogen levels, such as a number of births and the 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, of the Zhejiang University School of Medicine in Hangzhou, China, said the findings show estrogen exposure throughout life could be a useful indicator of a person’s stroke risk post-menopause.

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

‘These findings might help with new ideas for stroke prevention, such as considering screenings for people who have a short lifetime exposure to estrogen.’