Premature, Early Menopause Associated with Increased Risk of T2D
Researchers conducted a population-based study of women in Korea to analyze the association between age at menopause and incidence of type 2 diabetes.
Women with premature and early menopause had a higher risk of developing type 2 diabetes (T2D), according to data published in JAMA Network Open.1 Researchers’ findings suggest early detections of menopause may inform the management of T2D in women.
“Although the prevalence of T2D in young adults is higher in men, it increases in women from menopause to older age. Genetics, obesity, and lifestyle factors are well-known risk factors associated with T2D; however, research on women-specific risk factors is scarce,” wrote authors of the study.
T2D is an increasingly prominent disease globally and has been known to lead to long-term complications including cardiovascular disease (CVD), increased mortality, and microvascular issues. According to the CDC, 10% of the US population has diabetes with 95% of those individuals having T2D, accounting for up to 36 million Americans.2 Despite increased knowledge of the disease and treatment advancements, however, prevalence of T2D continues to increase and diabetes control rates continue to be low.
Premature menopause was defined as occurrence before 40 years old. | image credit: Yurii Kibalnik / stock.adobe.com
In this study, researchers decided to further explore menopause as a risk factor of T2D. Previous research has explored how female reproductive factors impact CVD as well as T2D, but not menopause’s specific link to T2D. Some studies have explored this association but were considered relatively small in scale and limited in population representation.
“Consequently, this study aimed to investigate whether age at menopause and premature menopause were associated with incident T2D in more than 1 million Korean women using a longitudinal follow-up study design,” they continued.1
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Researchers explored data from the Korean National Health Insurance Service (NHIS) of over 3 million women over 30 who underwent NHIS screening in 2009 and reported age at menarche. After conducting a population analysis of all women screened, a total of 1,125,378 participants (mean age, 61.2 years at enrollment and 50.0 years at menopause) were included in the study and followed up with until December 31, 2018.
The study’s primary end point was the occurrence of new-onset T2D at any time from the index date to the end of the study period. Researchers followed up with patients until they received a T2D diagnosis, they died, or the study period ended. Participants had a median follow-up time of 8.4 years.
“Age at menopause was assessed using a self-administered questionnaire and categorized into 4 groups: younger than 40 years, ages 40 to 44 years, ages 45 to 49 years, and age 50 years and older. Premature menopause was defined as menopause occurring before age 40 years, excluding individuals with a history of hysterectomy,” wrote the authors.1
Of the final study population, 113,864 individuals (10.1%) were diagnosed with T2D. Regarding women’s ages at menopause, 19,311 participants were under 40; 64,700 were between 40 and 44; 310,772 were between 45 and 49; and 730,595 were over 50.
“In this large-scale cohort study of more than 1.1 million Korean women, premature menopause was associated with an increased risk of T2D after adjusting for conventional cardiovascular risk factors,” they continued. “A younger age at menopause was associated with an increased risk of developing T2D.”
After analyzing study results, researchers looked to one specific factor of note that could lead to an association between T2D and menopause. When women experience early or premature menopause, they are left without estrogen for longer periods of time. With both estrogen and T2D showing possible links to menopause at earlier ages, researchers believe an estrogen deficiency could lead to increased T2D risk.
Based on previous research—including evidence that premature menopause is a risk factor for CVD—and study results, researchers suggested that early age at menopause should be recognized as a risk factor associated with T2D. Furthermore, they noted that keeping data on the history of premature menopause in women can serve as evidence for screening, treating, and preventing groups at risk of developing T2D.
“These findings suggest that premature menopause should be emphasized and considered an emerging risk factor in the management of T2D to delay disease progression and inform therapeutic strategies,” concluded the authors.2
READ MORE: Women's Health Resource Center
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References
1. Ko B, Jung J, Han K, et al. Age at menopause and development of type 2 diabetes in Korea. JAMA Netw Open. 2025;8(1):e2455388. doi:10.1001/jamanetworkopen.2024.55388
2. Type 2 diabetes. CDC. May 15, 2024. Accessed February 5, 2025. https://www.cdc.gov/diabetes/about/about-type-2-diabetes.html
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