In October our focus turns to women’s health as we join the world in breast cancer awareness campaigns. In Bermuda it’s hard to find someone who has not been personally affected by the disease. It may not be that they had it, but that a family member, friend or work colleague did. But despite breast cancer’s rate of incidence on the Island, heart disease actually claims the lives of more women every year.Government is tackling the problem through attention to the risk factors. Hypertension, diabetes and high cholesterol are the main three most of us have been made aware of but new research shows that early menopause is also a risk factor. A study in this month’s edition of the journal ‘Menopause’, shows that women who experience this change of life early, are twice as likely to suffer from coronary heart disease and stroke.Body & Soul spoke with lead researcher in the study Dhananjay Vaidya, an assistant professor in the division of General Internal Medicine at Johns Hopkins University School of Medicine.He said the findings should not frighten and scare women for whom this has happened but rather should alert them to be more vigilant in living a healthy lifestyle.“If physicians know a patient has entered menopause before her 46th birthday, they can be extra vigilant in making recommendations and providing treatments to help prevent heart attacks and stroke,” said Dr Vaidya. “If a woman knows she is at higher risk she can take greater care. She should have a higher motivation to implement recommendations like a healthy diet and regular exercise instead of waiting for angina to happen.”Good nutrition plays a key role. Dr Vaidya said looking at world trends over the 20th century, there is less early menopause than there used to be many years ago.“It’s one more reason why good nutrition is important for the growing child and young women,” he said.Results suggest it is also “important to avoid early menopause if at all possible”, he added.Menopause is part of the natural circle of life for women but some enter it early by having complete hysterectomies. According to Dr Vaidya, when a woman has a hysterectomy that includes removal of her ovaries, the hormones oestrogen and progesterone are no longer produced and she goes into menopause rapidly.He said it’s now important for women and their physicians to consider this option more closely as it’s clear that putting the body in early menopause significantly increases the risk of heart attack and stroke.“Perhaps ovary removal can be avoided in more instances,” he said.The research showed no difference in risk whether the women reached menopause surgically (through hysterectomies) or naturally. And there was no correlation with risk and ethnicity of the women.Dr Vaidya said previous studies conducted on white women showed this link between early menopause and increased risk of heart disease and stroke. His most recent study funded by the National Institute of Health and done with Melissa Wellons of the University of Alabama, was done with data collected in the Multi-Ethnic Study of Athersclerosis. This study was carried out between 2000 and 2008. It featured men and women aged between 45 and 84. Dr Vaidya’s study examined data on the 2,509 women.Of the women, 28 percent reported menopause before the age of 46. Dr Vaidya emphasised that although the risk of heart attack and stroke was doubled in this group, the actual number of cardiac and stroke events recorded among study participants was small.Only 50 women in the study suffered heart events, while 37 had strokes.“Cardiovascular disease processes and risks start very early in life, even though the heart attacks and strokes happen later in life,” said Dr Vaidya.“Unfortunately, young women are often not targeted for prevention, because cardiovascular disease is thought to be only attacking women in old age. What our study reaffirms is that managing risk factors when women are young will likely prevent or postpone heart attacks and strokes when they age.”