Pulmonary hypertension (PH) is high blood pressure in the blood vessels that supply the lungs (pulmonary arteries). It’s a serious condition that can damage the right side of the heart. The walls of the pulmonary arteries become thick and stiff, and cannot expand as well to allow blood through. Pulmonary hypertension appears to affect women more than men and it has been suggested that estrogen may affect the pulmonary blood vessels.

It is well known that untreated early or premature menopause can be associated with increased risk of later health problems such as osteoporosis and cardiovascular disease. A recently published study has shown that menopause before the age of 40 may also be associated with increased risk of pulmonary hypertension, with the risk being greater the earlier the menopause.

The study included 136,715 postmenopausal women (age, 40-69 years; 5201 (3.8%) had premature menopause) from the UK Biobank who were followed up for a median of 11.1 years.

Premature menopause was independently associated with a doubling of the risk of PH, although the numbers affected overall were small. The risk of PH increased progressively with younger age at menopause. Use of menopausal hormonal therapy was not associated with risk of PH and did not modify the association of premature menopause with PH.

Premature menopause may represent an independent risk factor for PH in women. Further investigation of the role of sex hormones in Pulmonary Hypertension is needed in animal and human studies to better understand why and to identify therapeutic targets.

This interesting study highlights again the importance of early or premature menopause and the need for women and healthcare professionals to be aware of later health implications, not just to focus on menopause symptoms.

Reference: Honigberg MC, Patel AP, Lahm T, Wood MJ, Ho JE, Kohli P, Natarajan P. Association of premature menopause with incident pulmonary hypertension: A cohort study. PLoS One. 2021;16(3):e0247398. doi: 10.1371/journal.pone.0247398. PMID: 33690615.  View full text