A large multinational cohort study published in Lancet Obstetrics, Gynaecology & Women’s Health (Marschner et al., 2026) provides important evidence on the association between premature and early menopause and major cardiovascular events across diverse regions and ethnic groups.
The Prospective Urban Rural Epidemiologic (PURE) study followed 111,619 women across 26 countries over a median of 14.6 years. Only cardiovascular disease events occurring after enrolment were included in the analysis.
The study found that premature and early menopause were consistently associated with a greater risk of major cardiovascular disease events across country income groups, geographical regions, and ethnic groups. A higher prevalence of premature and early menopause was observed among south Asian women and women in low- and middle-income countries, representing an additional independent cardiovascular risk factor in these populations. Conversely, later menopause was more common among European women and those in high-income countries.
Mr Haitham Hamoda, British Menopause Society says, “Women with premature and early menopause had approximately a 30% greater risk of major cardiovascular disease events after adjusting for cardiovascular risk factors, and this relationship was consistent across regions and ethnic groups. Premature and early menopause were significantly associated with increased risk of myocardial infarction, fatal cardiovascular disease, and stroke. These findings highlight the need for increased vigilance and proactive monitoring of cardiovascular risk in women with premature and early menopause.”
Professor Janice Rymer, British Menopause Society stated, “This large, multinational study confirms findings from earlier, smaller studies that premature and early menopause increase cardiovascular disease risk. The key message for healthcare professionals is clear: we must identify these women, ensure they understand the implications for their long-term health, and proactively manage their modifiable cardiovascular risk factors.”
Read the full study here: Early menopause and its association with cardiovascular outcomes (PURE): a multinational prospective cohort study