3 OCT 2026 — Most women reach menopause between 45 and 55. For many others it arrives earlier and suddenly, when both ovaries are removed in surgery or when cancer treatment stops them working. A review published on 2 October in JAMA Network Open, covering 36 studies and more than 2.6 million women, finds this induced menopause is linked to higher heart and stroke risk. The excess risk of death is concentrated in women who go through it before 45.
What the review covered
According to the paper, the researchers pooled observational studies and trials published from 2004 to March 2026. The studies compared women with medically or surgically induced menopause, known as iatrogenic menopause, with women who reached menopause naturally or with women of the same age. The studies followed women for a median of 16 years.
The World Health Organization notes that menopause can be induced by surgery that removes both ovaries, or by treatments such as chemotherapy or radiation that stop the ovaries working. Its fact sheet also says women's lower cardiovascular risk compared with men's gradually disappears as oestrogen falls after menopause.
The overall findings
Compared with other women, those with induced menopause had a 25% higher risk of cardiovascular events, a 48% higher risk of coronary heart disease and a 22% higher risk of stroke. Their risk of death from any cause was 8% higher. The authors describe the stroke link as the most consistent.
Why age matters
The excess deaths appeared only in women whose menopause was induced before 45. In that group, the risk of dying from cardiovascular disease was 20% higher and the risk of dying from any cause 15% higher. Women whose menopause was induced at 45 or later showed no increase.
In a further analysis, each five years older a woman was when her menopause was induced was linked to an 11% lower risk on the combined measure of cardiovascular illness and death. The authors describe the risk as falling progressively the older a woman was when her menopause was induced.
What it does not show
Because the review is built mostly on observational studies, it shows associations and cannot prove that induced menopause itself causes the extra risk. Women who need their ovaries removed young may differ in other ways that affect their hearts. The pooled studies also vary in how they defined groups and outcomes.
What it could mean in practice
The findings matter for decisions about removing ovaries in younger women when it is not strictly necessary, and for how closely women who go through early induced menopause are monitored for heart disease. The abstract does not set out specific clinical recommendations.
View author profile → · Editorial policy
