Early Menopause

Premature Menopause May Lead to Risk of Heart Failure, Atrial Fibrillation

Women who experience menopause prematurely—before 40 years of age— may have an increased risk of heart failure (HF) and atrial fibrillation (AF), according to a recent study.1

To produce their findings, the researchers examined the reproductive histories of postmenopausal women (n = 1,401,175) aged 30 years and older, which was provided by the Koran National Health Insurance Service in 2009. The researchers aimed to determine the association between premature menopause and age at menopause with HF and AF.

For the study, premature menopause was defined as a woman having her menstrual period before age 40 years. Age at menopause was grouped into the following categories: below 40 years of age, 40 to 44, 45 to 49, and 50 years and older. The mean follow-up of patients was 9.1 years. A total of 42,699 (3.0%) HF cases and 44,834 (3.2%) AF cases were reported during that period.

Women had an increased risk of HF (HR 1.33, 95% CI, 1.26 – 1.40) and AF (H: 1.09, 95% CI, 1.02 – 1.16) when there was a history of premature menopause compared with women without such history. When compared with women aged 50 years and older at menopause, women aged 45 to 49, 40 to 44, and less than 40 years at menopause showed a statistically significant increased risk of both HF and AF (P for trend < .001).  

A drop in estrogen levels and changes in a women’s body fat distribution during menopause were indicated as possible factors that explain the association between menopausal age, and HF and AF.

“Women with premature menopause should be aware that they may be more likely to develop heart failure or atrial fibrillation than their peers,” Ga Eun Nam, MD, PhD, of Korea University College of Medicine, Seoul, Republic of Korea said in a press release.2 “This may be good motivation to improve lifestyle habits known to be linked with heart disease, such as quitting smoking and exercising.”


—Jessica Ganga


  1. Shin J, Kyungdo H, Jung JH, et al. Age at menopause and risk of heart failure and atrial fibrillation: a nationwide cohort study. Eur. Published online August 4, 2022. doi:10.1093/euroheartj/ehac364.
  2. Premature menopause is associated with increased risk of heart problems. News Release. European Society of Cardiology; August 4, 2022. Accessed August 24, 2022.