New study suggests insulin resistance may partially explain the association between premature menopause and cardiovascular disease
CLEVELAND, Ohio (October 20, 2026)—Premature menopause is associated with an increased risk of several long-term health problems due to estrogen deficiency. Cardiovascular disease (CVD) is one of those health risks. However, the underlying cardiometabolic causes are unclear. A new study suggests a possible connection with insulin levels. Results of the study will be presented at the 2026 Annual Meeting of The Menopause Society in San Diego, October 20-24, 2026.
Premature menopause is defined as menopause that occurs before the age of 40 years. Only about 1% of women experience it. Women who experience premature menopause have a longer duration of postmenopause life and have been reported to have higher risks of several adverse health outcomes, including cardiovascular disease and osteoporosis.
A new study involving more than 4,700 postmenopausal women aged 45 to 64 years sought to examine cardiometabolic factors that may help explain the association between premature menopause and cardiovascular disease, with a particular focus on insulin resistance.
During a mean follow-up of 21.4 years, researchers documented 1,570 cardiovascular events among the participants. Compared with menopause that occurs at or after age 45 years, premature menopause was found to be associated with greater risks of cardiovascular disease and incident coronary heart disease but not stroke or heart failure. Early menopause, which occurs between the age of 40 and 44 years, was not associated with greater risks of any of these heart health problems. Similarly, premature menopause was associated with higher insulin levels—9.3% higher—but there was no difference in fasting glucose levels.
“Our findings suggest that insulin resistance may be one important pathway linking premature menopause with increased cardiovascular disease risk, highlighting the importance of cardiometabolic health in women who experience menopause before age 40,” says Dr. Zailing Xing, first author of the study.
Additional details of the study will be discussed as part of the presentation “Premature menopause and cardiovascular disease risk in the Aric Study: mediation by insulin resistance.”
“Women who experience menopause before age 40 are known to face a higher risk of cardiovascular disease, but the reasons for that increased risk are not fully understood,” says Dr. Stephanie Faubion, medical director for The Menopause Society. “This study suggests that insulin resistance may be one of the biological pathways involved. A better understanding of these mechanisms may help identify opportunities for earlier intervention and more personalized strategies to reduce long-term cardiovascular risk in women with premature menopause.”
For more information about menopause and healthy aging, visit www.menopause.org.
The Menopause Society is dedicated to empowering healthcare professionals and providing them with the tools and resources to improve the health of women during the menopause transition and beyond. As the leading authority on menopause since 1989, the nonprofit, multidisciplinary organization serves as the independent, evidence-based resource for healthcare professionals, researchers, the media, and the public and leads the conversation about improving women’s health and healthcare experiences. To learn more, visit menopause.org.