Review suggests menopausal symptoms may predict future health risks

A major review of menopause research has found that menopausal symptoms may be important early indicators of future health risks, including cardiovascular disease, diabetes, psychiatric disorders and reduced bone mineral density. 

This study was conducted via project PROPHECY (Predicting the Risks of Oestrogen-related Pathologies on Health Erosion to Conserve Healthy Years). PROPHECY (https://research.healthandher.com/pages/prophecy-project) is a research partnership between the Health & Her Centre for Research, Cardiff University and Swansea University, with grant funding provided by the Waterloo Foundation (https://waterloofoundation.org.uk/).   

The scoping review analysed 53 longitudinal studies involving more than 450,000 women from 28 international cohorts to examine how menopausal symptoms relate to long-term health outcomes. 

Researchers found consistent links between menopausal symptoms - particularly vasomotor symptoms such as hot flushes and night sweats - and increased risks of future cardiovascular disease and metabolic health problems. 

Women with persistent or severe vasomotor symptoms were more likely to experience poorer cardiovascular outcomes, with night sweats appearing more strongly linked to future cardiovascular risk than hot flushes alone. Several studies also associated menopausal symptoms with higher rates of insulin resistance, diabetes and metabolic syndrome. 

The review additionally found that women experiencing menopausal symptoms were more likely to develop future psychological difficulties, including depressive symptoms and psychiatric illness. However, the findings also suggested that psychological symptoms which first emerged during menopause often improved after menopause for many women. 

Similarly, cognitive symptoms such as memory difficulties and “brain fog” commonly appeared during perimenopause and often returned to premenopausal levels after menopause. However, some studies found cognitive decline persisted among women from lower socioeconomic backgrounds or those with higher levels of stress, trauma or limited social support. 

These findings highlight the importance of considering social and economic factors when supporting women through menopause and assessing longer-term health risks. 

The review also found associations between menopausal symptoms and reduced bone mineral density, suggesting symptoms during midlife could help identify women at greater risk of osteoporosis later in life. 

Interestingly, several studies linked symptomatic menopause with lower risks of breast cancer, although findings varied depending on symptom type and duration. 

Researchers noted major gaps in current menopause research. While vasomotor symptoms were widely studied, very little research explored the long-term effects of other common menopausal symptoms including sleep disturbances, fatigue, headaches, joint pain, urogenital symptoms and irregular periods. Key outcomes, such as dementia, were not explored in relation to menopausal symptoms.  

The authors also highlighted the lack of research involving more diverse populations, with most studies based in the United States and very limited evidence from Africa, Asia, the Middle East or Eastern Europe. 

They say future research should investigate whether treating menopausal symptoms earlier could help reduce later health risks, particularly cardiovascular disease and cognitive decline. 

The findings add to growing evidence that menopause symptoms may reflect wider changes in long-term health, rather than being solely temporary quality-of-life concerns. 

Reference 

Andrews R, Lacey A, Bache K, Kidd EJ. The role of menopausal symptoms on future health and longevity: A systematic scoping review of longitudinal evidence. Maturitas. 2024 Dec 1;190:108130. https://www.sciencedirect.com/science/article/pii/S0378512224002251