Age of Onset May Affect Stroke, Metabolic Syndrome Risk

• One study found that early natural menopause may be associated with a 27% higher risk of metabolic syndrome.
• Another study shows that later-onset menopause may have a lower risk of heart attack and stroke.
• Recent research found that muscle health scores were lower in postmenopausal females than in non-menopausal individuals.

Menopause is a natural part of the aging process. It marks the time in a person’s life when their period has been absent for 12 consecutive months, and they can no longer become pregnant.

This research has not yet been published in a peer-reviewed scientific journal. However, the findings underline the importance of early screening and prevention.

Another 2025 study found that those who begin menopause at age 55 years and older have healthier cardiovascular systems than those who stopped menstruating earlier. The findings help explain why females who enter menopause later have a lower risk of heart attack or stroke.

Biomarkers in urine may be able to detect early stage sarcopenia (muscle loss) in menopausal females, according to a 2025 study. The findings of the study were presented at the 2025 Annual Meeting of the Menopause Society. This research has not yet been published in a peer-reviewed journal.

The researchers analyzed the electronic health records from more than 234,000 females who had experienced natural menopause between the ages of 30 and 60.

Metabolic syndrome is a group of conditions that raise a person’s risk of serious health issues, such as:

The researchers found that among those who began menopause early, 13.5% were diagnosed with metabolic syndrome. Whereas, only 10.8% of those with later menopause had the condition.

The difference translated to a 27% increased relative risk of metabolic syndrome among those who experienced early menopause.

“Recognizing early menopause as a marker for metabolic syndrome gives clinicians a crucial window to identify at-risk women sooner and intervene earlier to prevent heart disease, diabetes, and other complications,” Shefali Setia Verman, PhD, assistant professor of Pathology and Laboratory Medicine at the University of Pennsylvania, and co-author of the study, stated in a press release.

The authors of the study explained that reduced levels of certain triglyceride-derived lipid metabolites contributed to lower oxidative stress, which leads to improved endothelial function.

Understanding these factors may help physicians personalize care for females throughout their lifetimes, reducing the risk of heart disease.

A female’s age at menopause can make a difference. If she begins menopause at 55 or older, her likelihood of developing heart disease is up to 20% lower than someone who stops having their menstrual cycle at a younger age.

The researchers measured brachial artery flow-mediated dilation in 92 females to assess how the upper-arm artery dilates when blood flow increases. They also measured their mitochondrial health and ran hormone tests to confirm menopause.

They also conducted analyses to determine what factors contributed to differences in mitochondrial reactive oxygen species bioactivity and endothelial function.

There was a difference between the late-onset menopause group and those who stopped menstruating earlier. The late-onset group had 24% worse vascular function than premenopausal females. The normal-onset group had 51% worse vascular function than premenopausal females.

This led the authors to suggest that females who go through later menopause are protected from the vascular dysfunction that can arise from oxidative stress.

Menopause is known to accelerate muscle loss due to hormonal changes, especially the reduction in estrogen levels. Current identification of the deterioration in the muscles is limited to DEXA scanning. This is expensive, often inaccessible, and not practical for routine monitoring.

A research team from Dalhousie University in Halifax, Nova Scotia, Canada, identified a novel urine biomarker that showed significant differences in muscle health between menopausal and nonmenopausal individuals. This was based on data from 113 participants.

The researchers collected urine samples from 85 individuals currently in menopause and 28 who were not menopausal after overnight fasting. They identified five key metabolites related to muscle metabolism. They then used a proprietary algorithm to combine biomarker concentrations into a single muscle health score for each participant.

The results were 91% concordant with the DEXA scan results for sarcopenia detection. Muscle health scores based on biomarkers were significantly lower in menopausal individuals than in nonmenopausal individuals (44.21% vs. 53.98%).

Menopausal individuals also showed lower levels of protein synthesis and higher levels of oxidative stress.

“We know that there are bone and muscle changes associated with menopause and aging,” Stephanie Faubion, MD, medical director of North American Menopause Society, who was not involved in the study, noted in an interview for a press release.

Faubion added that understanding the dynamic muscle changes that occur in midlife and menopause can be useful, she added.

However, she cautioned that the study’s findings were limited by a small sample size. More research is needed to clarify the measurement of muscle health and ensure the results have clinical implications.