Early Menopause and Its Link to Increased Risk of Fatty Liver Disease and Metabolic Disorders

Women who experience menopause before the age of 50, particularly before 45, face a greater likelihood of developing fatty liver disease and associated metabolic health issues shortly after menopause. This insight stems from a large-scale study presented at the joint congress of the European Society of Pediatric Endocrinology and the European Society of Endocrinology. The research underscores the importance of considering the age at natural menopause when assessing cardiometabolic risk.

Typically, menopause occurs between ages 45 and 55 as part of the natural aging process. However, women who go through menopause prematurely are at a higher risk of developing metabolic dysfunctions such as fatty liver disease, also known as metabolic dysfunction-associated steatotic liver disease (MASLD). MASLD is characterized by fatty accumulation in the liver, which can eventually lead to more serious liver conditions.

The study, conducted by researchers from Hadassah Medical Center and The Hebrew University of Jerusalem, analyzed data from 89,474 women. Participants were grouped based on their age at menopause: 40–44 years, 45–49 years, and those who had not yet reached menopause by age 50. Findings revealed that women experiencing menopause at 40–44 had a 46% higher risk of developing fatty liver disease within one year post-menopause. Moreover, early menopause was linked with an 11% increased risk of pre-diabetes and obesity, a 14% increased risk of hypertension, and a 13% increased risk of dyslipidemia.

Women who entered menopause at ages 45–49, termed early-normal menopause, also faced elevated risks—30% higher for fatty liver disease and 16% for pre-diabetes compared to women who had not yet undergone menopause. Previous research on this topic yielded inconsistent results, mainly due to small sample sizes and short follow-up periods. However, this study, with a follow-up duration of five years, strongly supports the hypothesis that early menopause is a significant risk factor for MASLD and related metabolic disorders.

The findings emphasize that menopause timing should be incorporated into comprehensive cardiometabolic risk assessments. The researchers plan to investigate whether hormone replacement therapy (HRT) could reduce these risks for women experiencing early menopause. Dr. Joshua Stokar, the lead author, noted that considering interventions like HRT might help mitigate the increased health risks associated with early menopause, especially given rising obesity rates and metabolic health issues among aging populations.

This research highlights the importance of early detection and intervention strategies for women at risk of metabolic diseases related to menopause timing, aiming to reduce long-term cardiovascular and liver health complications.