Patients with premature ovarian insufficiency and early menopause at high Multimorbidity risk, suggests study

A new study published in the journal of Fertility and Sterility showed that individuals with premature ovarian insufficiency (POI) and early menopause have higher rates of multimorbidity when compared to women going through menopause at a normal age.

Deficient ovarian sex hormones and a diminished ovarian reserve are the hallmarks of premature ovarian insufficiency, which combined cause an early onset of menopause and a rapid decline in ovarian function. Hot flashes, night sweats, and sleeplessness are just a few of the many menopausal symptoms brought on by the reduction in estrogen output.

A woman's health may suffer from a number of long-term negative effects from premature estrogen deprivation brought on by POI, such as an elevated risk of coronary artery disease, osteoporosis, dementia, diabetes, dyslipidemia, and other chronic illnesses that accelerate ageing and multimorbidity accumulation. Therefore, to compare the average age of menopause to that of patients with early menopause and premature ovarian insufficiency, Abirami Kirubarajan and colleagues undertook this study to describe the incidence of multimorbidity.

Women who had gone through menopause were included in this prospective cohort from the Canadian Longitudinal Study on Ageing (CLSA). The CLSA acquired cross-sectional data on 50,000 community-dwelling Canadians from 45 to 85 years of age between 2010 and 2015. Primary ovarian insufficiency, which is characterised by menopause beginning before age 40, was the main exposure. The age range of 46 to 55 years, early menopause (40-45 years), late onset menopause (56–65 years), and hysterectomy patients were the comparators. Multimorbidity, or having two or more chronic illnesses, was the main outcome. Severe multimorbidity and the frequency of particular chronic illnesses among a complete list of 15 distinct conditions comprised the secondary result.

A total of of 12,339 postmenopausal individuals were included, with 374 experiencing POI and 1396 undergoing early menopause. Multimorbidity was prevalent in 64.8% and 51.1% of patients with POI and early menopause, respectively. Also, only 43.9% of the women who reached menopause at the usual age had several medical conditions. The OR for multimorbidity in the POI sample was 2.5 times that of women who went through menopause at the typical age. This association remained after accounting for confounders. In addition, the POI group had double the prevalence of severe multimorbidity as the usual age group. Overall, the POI group had a considerably higher chance of developing ischemic heart disease, stomach ulcers, and osteoporosis.

Reference:

Kirubarajan, A., Sohel, N., Mayhew, A., Griffith, L. E., Raina, P., & Shea, A. K. (2024). The association between primary ovarian insufficiency and increased multimorbidity in a large prospective cohort (Canadian Longitudinal Study on Aging). In Fertility and Sterility. Elsevier BV. https://doi.org/10.1016/j.fertnstert.2024.08.345