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Women who experience menopause before the age of 50-particularly those entering menopause before 45-face a sharply elevated risk of developing fatty liver disease and related metabolic disorders within one year after menopause, according to new research presented at the first Joint Congress of the European Society of Paediatric Endocrinology (ESPE) and the European Society of Endocrinology (ESE).
Largest Study to Date on Menopause Timing and Metabolic Health
The study, led by researchers from Hadassah Medical Center and The Hebrew University of Jerusalem, analyzed health records from 89,474 women, making it the largest and most comprehensive investigation of its kind. Participants were grouped by age at menopause: 40–44 years (early), 45–49 years (early-normal), and those who had not reached menopause by age 50.
Key findings include:
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Women who underwent menopause between ages 40 and 44 had a 46% higher risk of developing metabolic dysfunction-associated steatotic liver disease (MASLD), commonly known as fatty liver disease, within one year after menopause compared to those who transitioned later or remained premenopausal.
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Early menopause was also linked to an 11% increased likelihood of pre-diabetes and obesity, a 14% higher risk of hypertension, and a 13% greater risk of dyslipidemia (unhealthy blood lipid levels).
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Women experiencing menopause between ages 45 and 49 had a 30% higher risk of fatty liver disease and a 16% increased risk of pre-diabetes compared to women who had not yet entered menopause by age 50.
Why Does Early Menopause Increase Risk?
Menopause typically occurs between ages 45 and 55, marking the end of ovarian function and a significant drop in estrogen levels. Estrogen is known to help regulate lipid and glucose metabolism, protect against fat accumulation in the liver, and maintain cardiovascular health. The loss of estrogen protection with early menopause appears to disrupt these processes, increasing vulnerability to fatty liver disease and other metabolic conditions.
Lead author Dr. Joshua Stokar emphasized, “Our study is the largest of its kind with a five-year follow-up period and provides support for the hypothesis that women are relatively protected from cardio-metabolic disease during the perimenopausal state. We believe our findings justify considering an earlier age at menopause-specifically before the age of 45-as a risk factor for MASLD”.
Implications for Women’s Health and Next Steps
These findings suggest that the age of natural menopause should be considered in cardiovascular and metabolic risk assessments for women. The research team plans to further investigate whether hormone replacement therapy (HRT) could help mitigate these risks in women who undergo early menopause, with clinical trials being proposed to assess its effectiveness.
With rising rates of obesity and an aging population, the identification of early menopause as a significant risk factor for fatty liver disease and metabolic disorders could help refine preventive health strategies and improve long-term outcomes for women worldwide.
Disclaimer:
This article summarizes findings from a recent scientific study presented at the Joint Congress of ESPE and ESE. The research is observational and does not establish direct causality. Individuals should consult healthcare professionals for personalized medical advice and before making decisions regarding menopause management or hormone replacement therapy.
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