Is There a Link Between Age of Menopause and Life Expectancy?

What is the latest understanding of the correlation between age of perimenopause/menopause and life expectancy? I’m 38 and have started to have irregular periods and mood swings and am wondering if I should panic, or at least look into HRT sooner rather than later.

—Panicking/not panicking

No need to panic, but you should get in to see your doctor. Different hormonal changes can cause irregular periods, and primary ovarian insufficiency (menopause before age 40) and early menopause (menopause before age 45) are not even the likeliest causes. An overactive thyroid, an underactive thyroid, or too much of the hormone prolactin are just a few other hormonal changes that can cause irregular periods.

Women under age 45 who have irregular periods should be evaluated for all causes of irregular periods. The reason it is important to evaluate younger women for other reasons their periods might be irregular is that in many cases we treat those problems entirely differently.

If it turns out that you are experiencing the early signs of menopause, there are various reasons to consider hormone therapy. First off, if you are symptomatic, your symptoms should be managed. Secondly, there are a number of risks associated with primary ovarian insufficiency and early menopause, including increased risk for heart disease and osteoporosis.

As for the question of longevity, there is some data that women who experience menopause after age 55 die later on average than women who experience natural menopause before age 40. I would be cautious in interpreting these types of studies. These are associations. There is no evidence that experiencing menopause later causes women to live longer. In fact, it is more likely that later menopause is an indicator of slower aging overall. The differences observed between the women who have menopause late and those who have menopause early is just two years. That is a fairly modest increase, when the life expectancy for women today is nearly 80. There is also no data that suggests that hormone therapy affects life expectancy in either direction.

The takeaway: If you are having irregular periods before age 45, you should be evaluated by your doctor. It could be an early sign of menopause, but more likely something else is causing your irregular periods. While age at menopause is associated with life expectancy, there is no evidence that later menopause causes women to live longer.