COMMENTARY

Longevity of Ovarian Function and Risk for Heart Failure

Andrew M. Kaunitz, MD

Disclosures

June 08, 2017

Previous reports have clarified that women with early menopause experience an elevated risk for cardiovascular disease (CVD). To study associations between reproductive function and risk for heart failure, investigators used a subgroup of women enrolled in the Women's Health Initiative (WHI) in whom no CVD was present at baseline. In this cohort of over 28,000 women, mean ages at menarche, menopause, and recruitment were 13, 47, and 63 years, respectively; mean years of follow-up was 13. Heart failure resulting in hospitalization was noted in almost 1500 women.[1]

Women with a longer overall reproductive duration were noted to have a lower risk for heart failure; race and ethnicity did not alter this overall finding.[1]

As the authors point out, a modestly elevated risk for heart failure in women with shorter duration of reproductive function might reflect the elevated risk for coronary heart disease (CHD) known to accompany early menopause. This is consistent with studies finding elevated rates of CHD with bilateral oophorectomy,[2] as well as the WHI menopausal hormone therapy (HT) clinical trial, which found a lower incidence of CHD when HT was initiated in recently menopausal women.[3]

Speaking of menopausal HT, this summer the North American Menopause Society (NAMS) will release its updated position statement on this topic. Once released, the NAMS will make this document available to the public at no charge on its website. Later this summer the statement will also appear in the NAMS journal Menopause. This updated statement will emphasize that, unless contraindications are present, menopausal HT is appropriate for symptomatic women in their 50s or within 10 years of menopause onset.[4]

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