Early Natural Menopause Associated With Increased Metabolic Syndrome Risk, According to New Research

Women who experience early natural menopause face a 27% higher relative risk of developing metabolic syndrome compared with those who undergo menopause later, according to findings from a large-scale study presented at the 2025 Annual Meeting of The Menopause Society in Orlando, Florida, October 21-25.

The analysis included electronic health record data from more than 234 000 women who experienced natural menopause between ages 30 and 60 years. Women whose menopause was induced by hysterectomy, bilateral oophorectomy, radiation, chemotherapy, or who were receiving hormone therapy were excluded from the study.

Prevalence Highest Among Women With Early Menopause

The overall prevalence of metabolic syndrome among study participants was 11.7%. When stratified by timing of menopause, the prevalence was 13.5% among women with early menopause and 10.8% among those with late menopause.

The association between early menopause and increased metabolic syndrome risk remained significant after adjustment for potential confounding factors, including medications, race, and body mass index.

"Our findings show that age at natural menopause isn't just a reproductive milestone—it's a powerful indication of long-term cardiometabolic risk," Shefali Setia Verman, MD, one of the study's authors from the University of Pennsylvania, said in a press release. "Recognizing early menopause as a marker for metabolic syndrome gives clinicians a crucial window to identify at-risk women sooner and intervene earlier to prevent heart disease, diabetes, and other complications."

Age at Menopause May Guide Risk Stratification

Metabolic syndrome comprises a cluster of risk factors, including obesity, hypertension, hyperglycemia, and elevated triglycerides. This combination increases risk for chronic diseases such as cardiovascular disease, stroke, and type 2 diabetes.

The researchers suggest that age at natural menopause may serve as a clinical indicator for metabolic risk stratification in postmenopausal women. Early identification could be important for reducing risk of comorbidities including insulin resistance, type 2 diabetes, and cardiovascular disease.

"This is yet another example of how premature and early menopause are linked with increased risk for adverse health outcomes," Stephanie Faubion, MD, medical director for The Menopause Society and director of the Mayo Clinic Center for Women's Health, said in a press release. "The more we can understand these potential risks, the better our ability intervene early in order to offset these risks."

Early Menopause Linked to Cardiovascular Disease, Dementia, Osteoporosis

The findings add to a growing body of evidence linking early menopause with multiple adverse health outcomes, Faubion told Patient Care® in a phone interview during TMS 2025. "Women who go through menopause early, like particularly under 40, that you're talking about women who are in their 30s when they go through menopause," Faubion said. "They have an increased risk of heart attack and stroke and dementia and early death, actually, and a lot of this is because of excess cardiovascular risk."

Faubion emphasized the importance of hormone therapy for women experiencing early menopause. "People who go through menopause early and don't get estrogen, they should get estrogen. Absolutely, 100% should get estrogen unless there is a very clear contraindication to its use, like an active breast cancer, because they're at increased risk for all of these adverse effects," she said.

Other conditions associated with early menopause include osteoporosis and potentially increased lung cancer risk, though breast cancer risk may be lower in this population.

Clinicians Often Miss Menopause History During Midlife Visits

Faubion noted that recognition of early menopause as a risk factor may not be widespread in clinical practice. "When women are coming around into the office around midlife, and they're coming in in their 50s, and they're wondering what to do with their health, clinicians rarely ask about their obstetric history and when they actually went through menopause or had their ovaries out or whatever," she said.

"Clinicians need to be aware that premature and early menopause do come with increased risk for a number of adverse health outcomes that can impact brain health, bone health and heart health, and that those need to be addressed throughout the lifespan, not just at midlife," Faubion stated to Patient Care.

The decrease in estrogen that occurs with menopause is thought to contribute to the increased prevalence of metabolic syndrome, as estrogen provides protective effects against metabolic conditions.

References:

1. Setia Verman S, et al. Prevalence and risk factors of metabolic syndrome in women with natural menopause. Abstract presented at: 2025 Annual Meeting of The Menopause Society; October 21-25, 2025; Orlando, FL.
2. Early Natural Menopause Linked with Higher Risk of Metabolic Syndrome. The Menopause Society. News release. October 21, 2025. Accessed October 21, 2025. https://menopause.org/press-releases/early-natural-menopause-linked-with-higher-risk-of-metabolic-syndrome