Overview
- The Prospective Urban Rural Epidemiology (PURE) study, published this week in The Lancet Obstetrics, Gynaecology & Women’s Health, analysed more than 111,000 women from 26 countries and followed them for about 15 years.
- Across the sample roughly 9.5% of women had premature menopause (before 40) and 15.3% had early menopause (ages 40–44), with premature menopause linked to a 27% higher risk of major cardiovascular events and early menopause to a 14% higher risk.
- Women in low- and middle-income countries reached menopause earlier on average and faced about a 53% greater risk of premature menopause than women in high-income countries, and South Asian women had about a 34% higher risk of premature menopause compared with European women.
- Authors caution that in some poorer settings missed periods can reflect hypothalamic amenorrhea from malnutrition or extreme physical stress rather than true ovarian failure, which can make reported menopause ages appear earlier and partly inflate geographic gaps.
- Researchers say the link persisted after adjusting for traditional risk factors and note biological reasons for the effect—loss of estrogen’s protection on blood lipids and vessels—and they call for routine cardiovascular risk assessment, lifestyle support, and context-appropriate clinical care for women with early or premature menopause.