Effect of Iron Levels on Women After Premature or Early-Onset Menopause

To the Editor In a systematic review, Muka et al¹ found a higher risk of cardiovascular disease mortality and a higher overall mortality in women who experience premature or early-onset menopause. We suggest that the substantial increase in serum ferritin levels at menopause signals a dramatic alteration in iron metabolism possibly associated with enhanced inflammatory responses. We ask the authors to consider that the observed and significant increase in risk of cardiovascular disease in women is associated with altered iron homeostasis and the possible increase in body iron stores after menstrual blood flow cessation.²