The DOI matches its Crossref record; 53 of the 53 references it cites were found in a registry or an index.
Premature menopause or early menopause and risk of ischemic stroke
Open accessAbstract
In Brief Objective The general consensus has been that estrogen is invariably a risk factor for ischemic stroke (IS). We reviewed new observational studies that challenge this simple conclusion. Methods This was a review of observational studies of the association of premature or early menopause with stroke or IS published in English from 2006 through 2010. Results Three cohort studies showed an increased risk of all types of stroke in women who underwent bilateral oophorectomy compared with women who conserved their ovaries before age 50 years. The increased risk of stroke was reduced by hormone therapy in one of the studies, suggesting that estrogen deprivation is involved in the association. Four additional observational studies showed an association of all types of stroke or IS with the early onset of menopause or with a shorter life span of ovarian activity. In three of the seven studies, the association was restricted to IS. Age at menopause was more important than type of menopause (natural vs induced). Conclusions The findings from seven recent observational studies challenge the consensus that estrogen is invariably a risk factor for IS and can be reconciled by a unifying timing hypothesis. We hypothesize that estrogen is protective for IS before age 50 years and may become a risk factor for IS after age 50 years or, possibly, after age 60 years. These findings are relevant to women who experienced premature or early menopause or to women considering prophylactic bilateral oophorectomy before the onset of natural menopause. The findings from seven recent observational studies challenge the consensus that estrogen is invariably a risk factor of ischemic stroke. In this study, a unifying theory is proposed, in which estrogen is protective before approximately age 50 years and may become a risk factor of ischemic stroke after age 50 years or, possibly, after age 60 years.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Treatment with estrogens until age 45 years or longer may reduce the risk of cardiovascular disease and mortality (47,49,51).”
From Hormonal Replacement in Hypopituitarism in Adults: An Endocrine Society Clinical Practice Guideline (2016) · cites this paper as [49]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Treatment with estrogens through age 45 years or longer may reduce the risk of cardiovascular disease and mortality (47,49,51).”
From Hormonal Replacement in Hypopituitarism in Adults: An Endocrine Society Clinical Practice Guideline (2016) · cites this paper as [49]
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
The Protective Effects of Estrogen on the Cardiovascular System
Mendelsohn, M. E., & Karas, R. H. (1999) · New England Journal of Medicine · doi:10.1056/nejm199906103402306 · Cited by 3,119
A Randomized Trial of Low-Dose Aspirin in the Primary Prevention of Cardiovascular Disease in Women
Ridker, P. M., Cook, N. R., Lee, I.-M., Gordon, D., Gaziano, J. M., Manson, J. E., Hennekens, C. H., & Buring, J. E. (2005) · New England Journal of Medicine · doi:10.1056/nejmoa050613 · Cited by 1,945
Postmenopausal hormone therapy and risk of cardiovascular disease by age and years since menopause
Rossouw, J. E., Prentice, R. L., Manson, J. E., Wu, L., Barad, D., Barnabei, V. M., Ko, M., LaCroix, A. Z., Margolis, K. L., & Stefanick, M. L. (2007) · JAMA · doi:10.1001/jama.297.13.1465 · Cited by 1,741
Effect of Estrogen Plus Progestin on Stroke in Postmenopausal Women
Wassertheil-Smoller, S. W., Hendrix, S. L., Limacher, M. C., HEISS, G. M., Kooperberg, C. L., Baird, A. E., Kotchen, T. A., Curb, J. D., Black, H. R., Rossouw, J. E., et al. (2003) · JAMA · doi:10.1001/jama.289.20.2673 · Cited by 1,160
Molecular and Cellular Basis of Cardiovascular Gender Differences
Mendelsohn, M. E., & Karas, R. H. (2005) · Science · doi:10.1126/science.1112062 · Cited by 1,105 · cited 2×
“Because estrogen induces several beneficial antiatherogenetic and vasoprotective effects as well as detrimental prothrombotic and proinflammatory effects, it might modify the risk of IS differentially, based on IS subtype.(13,33,34) In addition, the balance of these differential effects might vary with age.”
BackgroundNational Use of Postmenopausal Hormone Therapy
Hersh, A. L., Stefanick, M. L., & Stafford, R. S. (2004) · JAMA · doi:10.1001/jama.291.1.47 · Cited by 984
Premature menopause or early menopause: Long-term health consequences
Shuster, L. T., Rhodes, D. J., Gostout, B. S., Grossardt, B. R., & Rocca, W. A. (2009) · Maturitas · doi:10.1016/j.maturitas.2009.08.003 · Cited by 845 · cited 3×
“4 y).(16,17) Premature menopause or early menopause can be spontaneous or induced; if induced, it can be due to medical Received April 4, 2011; revised and accepted June 22, 2011.”
BackgroundSelf-citationVos, M. D., Devroey, P., & Fauser, B. C. J. M. (2010) · The Lancet · doi:10.1016/s0140-6736(10)60355-8 · Cited by 781
Petty, G. W., Brown, R. D., Whisnant, J. P., Sicks, J. D., O’Fallon, W. M., & Wiebers, D. O. (1999) · Stroke · doi:10.1161/01.str.30.12.2513 · Cited by 729 · cited 7×
“Under this hypothesis, the different risks of stroke and coronary heart disease associated with HT at ages 50 to 59 years may be, in part, due to the differential mechanisms of cardioembolic IS.(31,32)”
BackgroundInfluentialSelf-citationEstrogen Therapy and Coronary-Artery Calcification
Manson, J. E., Allison, M. A., Rossouw, J. E., Carr, J. J., Langer, R. D., Hsia, J., Kuller, L. H., Cochrane, B. B., Hunt, J. R., Ludlam, S. E., et al. (2007) · New England Journal of Medicine · doi:10.1056/nejmoa071513 · Cited by 711
Cited by
Sorted by citations
El Khoudary, S. R., Aggarwal, B., Beckie, T. M., Hodis, H. N., Johnson, A. E., Langer, R. D., Limacher, M. C., Manson, J. E., Stefanick, M. L., Allison, M. A., et al. (2020) · Circulation · doi:10.1161/cir.0000000000000912 · Cited by 1,219
2016 IMS Recommendations on women’s midlife health and menopause hormone therapy
Baber, R., Panay, N., & Fenton, A. J. (2016) · Climacteric · doi:10.3109/13697137.2015.1129166 · Cited by 968
Hormonal Replacement in Hypopituitarism in Adults: An Endocrine Society Clinical Practice Guideline
Fleseriu, M., Hashim, I. A., Karavitaki, N., Melmed, S., Murad, M. H., Salvatori, R., & Samuels, M. H. (2016) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2016-2118 · Cited by 945
Bushnell, C., McCullough, L. D., Awad, I. A., Chireau, M. V., Fedder, W. N., Furie, K. L., Howard, V. J., Lichtman, J. H., Lisabeth, L. D., Piña, I. L., et al. (2014) · Stroke · doi:10.1161/01.str.0000442009.06663.48 · Cited by 941
“The association between onset of menopause and stroke risk has been the subject of 2 recent reviews, one focusing on the association of age at menopause and stroke risk and the other focusing on the association of premature or early menopause and stroke risk.(237,238) In the first review by Lisabeth and Bushnell,(237)…”
BackgroundMuka, T., Oliver-Williams, C., Kunutsor, S., Laven, J. S. E., Fauser, B. C. J. M., Chowdhury, R., Kavousi, M., & Franco, O. H. (2016) · JAMA Cardiology · doi:10.1001/jamacardio.2016.2415 · Cited by 826
Metadata
- Authors
- Rocca, W. A., Grossardt, B. R., Miller, V. M., Shuster, L. T., & Brown, R. D.
- Affiliations
- Mayo Clinic (US)
- Department of Medical Sciences (BY)
- Corresponding author
- Rocca, Walter A.
- Venue
- Menopause
- Published
- 2012-03
- Volume
- 19
- Issue
- 3
- Pages
- 272-277
- ISSN
- 1072-3714 (ISSN-L)
- PMC
- PMC3258468
- OpenAlex
- W2016373832
- Semantic Scholar
- 5046b0fb75f713a0ec75734faf7bbf9842dc66db
- Cited by
- 188
- References
- 53
- Citations by year
- 2026: 8 · 2025: 8 · 2024: 9 · 2023: 12 · 2022: 5 · 2021: 10 · 2020: 11 · 2019: 31 · 2018: 11 · 2017: 14 · 2016: 15 · 2015: 11 · 2014: 17 · 2013: 13 · 2012: 12
- FWCI
- 1.92
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Menopause The Journal of The North American Menopause Society (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Aging (R01AG034676, AG-034676)
- National Institute of Neurological Disorders and Stroke (NS 033978, R01NS033978)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Endocrinology › Estrogen and related hormone effects
- Health Sciences › Medicine › Clinical Neurology › Acute Ischemic Stroke Management
- Keywords
- premature menopause, early menopause, ischemic stroke, estrogen, estrogen deprivation, bilateral oophorectomy, hormone therapy, timing hypothesis, ovarian function
- MeSH terms
- Female, Humans, Menopause, Premature, Ovariectomy, Risk, Cohort Studies, Hormone Replacement Therapy, Stroke
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
