Earlier diabetes diagnosis linked to younger age at natural menopause
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Women diagnosed with type 1 diabetes before age 30 years or type 2 diabetes at age 30 to 39 years are more likely to reach menopause earlier than women without diabetes, according to study results.
Data were presented at the North American Menopause Society annual meeting.
“With more females being diagnosed with diabetes at younger ages, clinicians need to take into account the long-term health implications this will have on their reproductive health, including age at natural menopause,” Vrati M. Mehra, MSc, an MD candidate at the University of Toronto Temerty Faculty of Medicine, told Healio.
Mehra and colleagues analyzed baseline data from the Canadian Longitudinal Study on Aging. The study included 11,436 women diagnosed with type 1 diabetes, type 2 diabetes or gestational diabetes prior to menopause. Age at natural menopause was the primary outcome of the analysis. Researchers also calculated the median age at natural menopause for each diabetes type.
The cohort’s median age at natural menopause was 52 years. After adjusting for ethnicity, education, smoking, premenopausal factors and other covariates, women diagnosed with type 1 diabetes at younger than 30 years (adjusted HR = 1.55; 95% CI, 1.05-2.29) and those diagnosed with type 2 diabetes at age 30 to 39 years (aHR = 1.82; 95% CI, 1.12-2.95) were more likely to have younger age at natural menopause than women with no diabetes. Mehra said the association between type 2 diabetes and age at natural menopause was surprising.
“Based on previous studies, there was some indication that women with type 1 diabetes may be the ones to have earlier menopause and women with type 2 diabetes have later menopause because type 2 diabetes is traditionally diagnosed in older ages,” Mehra said. “As such, we weren’t expecting an earlier diagnosis of type 2 diabetes to be significantly related to age at natural menopause.”
There was no association found between gestational diabetes and age at natural menopause. Women diagnosed with type 2 diabetes at older than 50 years were more likely to have later age at natural menopause than women with no diabetes (aHR = 0.39; 95% CI, 0.27-0.56).
“We would recommend that clinicians inform their young patients with both type 1 and type 2 diabetes of this potential association between early diagnosis of diabetes and age at natural menopause and be ready to support their patients in this transition,” Mehra said. “We also don’t know how premenopausal diabetes impacts women’s experience of menopausal symptoms, such as vasomotor symptoms, but we are all learning just how serious those symptoms can be, so we would recommend paying closer attention to your patients’ history of diabetes and supporting them in this transition. I also must stress that we need more public health support with primary prevention of diabetes. We must do our best to curb the growing epidemic of diabetes among younger individuals.”
Mehra said more research is needed to better understand the mechanisms behind diabetes status and age at natural menopause, and to confirm the impact of long-standing diabetes and history of gestational diabetes on reproductive health.
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Mehra V, et al. S-6. Presented at: North American Menopause Society Annual Meeting; Oct. 12-15, 2022; Atlanta.
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