Early Onset of Menopause Linked to Increased Risk of Fatty Liver Disease and Metabolic Disorders

Recent research presented at the inaugural Joint Congress of the European Society of Pediatric Endocrinology (ESPE) and the European Society of Endocrinology (ESE) indicates that women who undergo menopause before the age of 50, particularly those experiencing it before the age of 45, face a heightened risk of developing fatty liver disease and associated metabolic disorders within a year after menopause.

The study, conducted by researchers from Hadassah Medical Center and The Hebrew University of Jerusalem, is the largest of its kind, evaluating data from 89,474 women over a five-year period. It emphasizes the importance of considering the age at which women reach menopause as a significant factor in assessing cardiometabolic risks.

Menopause typically occurs between the ages of 45 and 55 as a natural part of aging. Following menopause, women are at a greater risk for long-term health complications, including fatty liver disease, medically recognized as metabolic dysfunction-associated steatotic liver disease (MASLD). This condition arises from excess fat accumulation in the liver, with risk factors increasing sharply around the average age of menopause. However, the relationship between the timing of menopause and the onset of MASLD has been poorly understood until now.

The findings reveal that women who enter menopause between the ages of 40 and 44 are 46% more likely to develop fatty liver disease within the first year post-menopause. Furthermore, early menopause correlates with an 11% increased risk of pre-diabetes and obesity, a 14% higher likelihood of hypertension, and a 13% greater risk of dyslipidemia, which refers to unhealthy lipid levels in the bloodstream.

In comparison, women aged 45 to 49 at the onset of menopause--classified as experiencing early-normal menopause--exhibit a 30% increased risk of fatty liver disease and a 16% higher risk of pre-diabetes compared to those who have not yet entered menopause by age 50.

Prior studies investigating the link between menopause timing and MASLD have produced inconsistent results, often hampered by limited participant numbers and short follow-up durations. The lead researcher notes that their comprehensive study provides substantial evidence supporting the notion that younger women are afforded some protection against cardiometabolic diseases during the perimenopausal transition.

The research team plans to further explore the implications of hormone replacement therapy (HRT) in women approaching menopause and those who have already experienced it. The lead researcher advocates for clinical trials to determine whether HRT could potentially reduce the risk of MASLD in women who undergo menopause at an earlier age.

As the global population ages and the prevalence of obesity and metabolic disorders rises, addressing these health risks through effective interventions could significantly alleviate the burden of cardiometabolic diseases among post-menopausal women.