Early menopause: what it means for your heart and bones

If your periods stopped before 45, your heart and bones need more attention, and your GP needs to know. About 1 in 15 Australian women go through menopause early (before 45) or have premature ovarian insufficiency (before 40). A new US study, shared by The Menopause Society in October 2026, found women whose menopause came before 40 had higher insulin levels and a higher risk of coronary heart disease over the following decades. It is not a reason to panic. It is a reason to get checked, talk to your GP about treatment, and look after your heart and bones from now on.

What counts as early or premature menopause?

Menopause is your final period. In Australia it usually happens between 45 and 55, with an average age of around 51.

• Premature menopause, or premature ovarian insufficiency (POI): menopause before 40. The ovaries stop working normally and make much less oestrogen.
• Early menopause: menopause between 40 and 45.

It can happen on its own, often with no known cause, or because of surgery to remove both ovaries, or cancer treatments like chemotherapy and radiation. Having a hysterectomy that leaves your ovaries in place does not cause menopause, though it can make it harder to tell when menopause happens.

The Australian Government estimates about 1 in 15 women in Australia experience POI or early menopause.

What did the new study find?

Researchers used the long-running US ARIC study, which followed more than 4,700 postmenopausal women for an average of 21 years. Here is what they reported:

• Menopause before 40 was linked to a higher risk of coronary heart disease and cardiovascular disease than menopause at 45 or later.
• Insulin levels were about 9% higher in women with menopause before 40, while fasting blood sugar was the same. That points to insulin resistance as one possible pathway.
• Menopause at 40 to 44 was not linked to extra risk in this study.

This was observational research presented at a conference. It shows a link, not cause and effect, and the full paper has not been published yet.

Does early menopause raise heart disease risk?

The new study adds to a much bigger body of evidence. In 2019, an international team led by researchers at the University of Queensland pooled data from more than 300,000 women. Compared with women whose menopause came at 50 or 51:

• women with menopause before 40 had about a 55% higher risk of a non-fatal cardiovascular event before age 60
• women with menopause between 40 and 44 had about a 30% higher risk

So while the new US study did not find extra risk at 40 to 44, the larger Australian-led analysis did. The safest reading: the earlier your menopause, the more attention your heart deserves.

Why? Oestrogen helps keep blood vessels flexible, supports healthy cholesterol levels, and affects how your body handles insulin. Losing it years earlier means more years without that support.

What about your bones?

The Australasian Menopause Society lists osteoporosis as one of the main long-term risks of POI. Bone loss speeds up when oestrogen falls, so the earlier that happens, the longer your bones are exposed.

That is why bone density checks and bone-loading exercise matter more if your menopause was early.

Talk to your GP about treatment

If your menopause was early, talk to your GP or a menopause specialist about treatment options for your symptoms, heart and bones. Your health history matters to that decision.

This is different from MHT decisions at the usual age of menopause. If your menopause was early, have a specific conversation with your GP or a menopause specialist about it.

What should you do if your menopause was early?

1. Tell your GP your age at your last period. It is now recognised as a risk factor for heart disease, but it is easy to leave out of the conversation. Make sure it is in your notes.
2. Talk to your GP about treatment options. Tell them if your menopause was before 40.
3. Get your heart checked. Blood pressure, cholesterol, blood sugar, waist measurement. Ask whether a Heart Health Check is right for you.
4. Ask about a bone density scan. Early menopause is a reason to check sooner.
5. Strength train twice a week. It loads your bones, builds muscle, and helps your body use insulin better.
6. Move every day. Walking, cycling or swimming all count towards heart health.
7. Look after the basics. Do not smoke, keep alcohol low, prioritise sleep, and eat plenty of vegetables, legumes, wholegrains and protein.

If you're in your 30s and something feels off

Irregular or missing periods, hot flushes, night sweats, or new trouble sleeping in your 30s are worth raising with your GP. Unlike at 45 or older, hormone blood tests do matter here. The AMS says diagnosis of POI involves missed periods for more than four months and FSH levels in the menopausal range on two tests at least four to six weeks apart, after other causes are ruled out.

Early menopause can also bring grief, especially around fertility. Support is available, and it is OK to ask for it.

The bottom line

Early menopause is more common than most women realise, and it changes your long-term health picture. The good news is there is a lot you can do: know your number, tell your GP, discuss treatment with your GP, and put your heart and bones first.