For years, menopause has largely been discussed in terms of hot flushes, mood swings and the end of menstrual cycles. But new global research suggests it could also be an important marker for your future heart health, especially if you're a South Asian woman.
A large international study published in The Lancet Obstetrics, Gynaecology & Women's Health has found that women from South Asia and low- and middle-income countries are more likely to experience menopause earlier than women in high-income countries. More importantly, earlier menopause is linked with a significantly higher risk of cardiovascular disease later in life.
What did the study find?
Researchers analysed data from over 111,000 women across 26 countries as part of the Prospective Urban Rural Epidemiologic (PURE) study, making it one of the largest studies of its kind.
Some of the key findings include:
- Women in low- and middle-income countries were 53% more likely to experience premature menopause than women in high-income countries.
- Half of women in these countries reached menopause at 47.5 years, compared to 50.6 years in high-income nations.
- South Asian women had a 34% higher risk of premature menopause than European women.
- The average age of menopause among South Asian women was 47.4 years, compared with 50.7 years among European women.
What counts as early menopause?
Doctors define:
- Premature menopause as menopause occurring before the age of 40
- Early menopause as menopause occurring between 40 and 44 years
Although the average age remains above these thresholds, researchers found that women from South Asia are more likely to enter menopause earlier overall.
Why does this matter?
Menopause naturally lowers oestrogen levels, a hormone that helps protect blood vessels and supports heart health. When menopause happens earlier, women spend more years without this protective effect.
The study found that:
- Early menopause increased the risk of major cardiovascular events by 14%.
- Premature menopause increased the risk by 27%.
These events include heart attacks and strokes. Researchers also found that this link remained consistent across different countries, ethnicities and income groups, suggesting that early menopause itself may be an independent risk factor for heart disease.
It's About More Than Age
Interestingly, women in low- and middle-income countries experienced higher rates of cardiovascular disease despite having lower rates of traditional risk factors such as obesity, diabetes and high blood pressure.
Researchers believe other factors may contribute, including:
- Air pollution
- Poor nutrition
- Lower access to healthcare
- Socioeconomic inequalities
- Lower physical strength
- Earlier menopause
Together, these create a more complex picture of women's heart health than previously understood.
What Can Women Do?
You can't control when menopause begins, but you can reduce your future cardiovascular risk.
Experts recommend:
- Having regular blood pressure, cholesterol and blood sugar checks
- Staying physically active with strength and aerobic exercise
- Eating a heart-healthy diet rich in fruits, vegetables, whole grains and healthy fats
- Avoiding smoking
- Speaking to your doctor if menopause occurs before the age of 45
Knowing your menopause timeline is no longer just about fertility or hormones, it may offer valuable insight into your long-term heart health.
The Bottom Line
This research is an important reminder that women's health doesn't stop at menopause, it changes. For South Asian women in particular, earlier menopause could become an important signal for future cardiovascular risk. Rather than causing alarm, it offers an opportunity for earlier screening, healthier lifestyle choices and better conversations with healthcare providers.