Long-term health effects of early menopause: Health Practitioners’ perspectives

Women diagnosed with spontaneous early menopause, Premature Ovarian Insufficiency (POI), or medically-induced early menopause can experience a range of symptoms which vary in severity and duration (see Symptoms of early menopause). In the long-term, early menopause (EM) can also lead to the loss of bone density (osteoporosis) and negatively impact and cardiovascular disease risk and cognitive function.

The health practitioners we interviewed emphasised the importance of pharmacological therapies (see Hormone-based medications for early menopause) such as Hormone Replacement Therapy (HRT), also known as Menopausal Hormone Therapy, where possible, and lifestyle changes (see Lifestyle changes following early menopause) to help reduce the long-term health risks of EM especially bone health.

Dr C, an obstetrician-gynaecologist, discussed the long-term health effects of POI / EM on women.

While younger women experiencing EM can initially have good bone density and cardiovascular health, health practitioners explained that it is important to monitor them for any changes over time. Dr Baber, an obstetrician-gynaecologist, said, ‘it depends on the age of the patient and on her history, and her family history … But I think you should do a baseline assessment on most of them. If they’re teenagers they’re obviously going to have normal bones and a normal heart, but you do need to follow that regularly as time goes by.’

A few health practitioners remarked that younger women diagnosed with EM may not monitor their bone density as regularly as older women. Breast surgeon Dr P attributed this in part to the fact that their friends or relatives who are of a similar age have different health concerns and so ‘their peers are unlikely to tell them, you know, ‘Have you gone and had your bone density done yet?’ because they’re just not in that … phase of their life.’

In clinical psychologist Dr G’s experience, younger women sometimes need more encouragement to monitor their bone density.

Dr D, an endocrinologist, explained how she monitors younger women’s cardiovascular health.

Health practitioners spoke of the importance of prevention when monitoring women’s bone, cardiovascular and cognitive health. They emphasised offering women HRT where possible, until the usual age of menopause (about 51 years old) and encouraging lifestyle changes such as exercise (see Lifestyle changes following early menopause).

General practitioner Dr Goeltom discussed the importance of lifestyle changes following EM and prevention of the long-term health effects of EM.

Monitoring women diagnosed with EM following cancer treatment for long-term health impacts, in particular osteoporosis, was also seen as important. Dr Goeltom explained that women diagnosed with oestrogen-positive cancer who may be unable to take HRT should do ‘weight-bearing exercise, and [take] calcium, and Vitamin D’ to help protect their bone density.

Oncologist Dr S reflected on how the bone density and cardiovascular health of women with EM related to cancer treatment is monitored and dealt with in the oncology setting.

For Dr Baker, a breast surgeon, it is essential to screen women diagnosed with cancer for vitamin D during first consultations.

A few health practitioners who are involved in the care of women with EM or menopausal symptoms related to cancer treatment remarked that hormone (adjuvant endocrine) therapies for cancer, such as aromatase inhibitors have a higher risk of negatively affecting bone density.

Ms Hay, a breast care nurse, explained how women on aromatase inhibitors need to undergo repeated tests to monitor changes in their bone density.

Further information

Talking Points (health practitioners)

Talking Points (women)

Other resources