Fatty Liver Disease Risk 46 Percent Higher in Women with Menopause Before 45: Study Finds
Women who experience menopause before the age of 50-and especially before the age of 45-are more likely to develop fatty liver disease and its related metabolic risk factors within one year after menopause, according to research presented at the first Joint Congress between the European Society of Paediatric Endocrinology (ESPE) and the European Society of Endocrinology (ESE).
This study is the largest to assess this association over five years and suggests that the age of natural menopause should be considered part of the cardio-metabolic risk assessment in women.
Most women experience menopause between the ages of 45 and 55 as a natural part of biological ageing. After menopause, women are at a higher risk of long-term health problems such as fatty liver disease and its related metabolic risk factors — also known as metabolic dysfunction-associated steatotic liver disease (MASLD), a condition caused by a build-up of fat in the liver.
In this study, researchers examined 89,474 women and grouped them according to their age at menopause: 40–44 years, 45–49 years and those who had not yet gone through menopause by age 50. The researchers found that women who experienced menopause aged 40–44, which is classed as early, had a 46% higher risk of fatty liver disease within one year after menopause.
In addition, early menopause was associated with an 11% increased likelihood of pre-diabetes and obesity, a 14% increased risk of hypertension, and a 13% increased risk of dyslipidemia. Similarly, women aged 45–49 who entered menopause had a 30% higher risk of fatty liver disease and 16% higher risk of pre-diabetes than those women who had not entered menopause.
The study concluded women who experience menopause before the age of 45 have a higher risk of developing fatty liver disease and its metabolic risk factors, including high blood pressure and obesity. “Previous research on this association has reached conflicting results but was limited by small numbers of participants and short follow-up,” said lead author Dr Joshua Stokar.
“Our study is the largest of its kind with a five-year follow-up period and provides support for the hypothesis that women are relatively protected from cardio-metabolic disease during the perimenopausal state,” said Dr Stokar. “We believe our findings justify considering an earlier age at menopause — specifically before the age of 45 — as a risk factor for MASLD.”
Reference: https://espe-ese-congress2025.org/wp-content/uploads/2025/05/press_release_Stokar-final.pdf
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