BRCA1 or BRCA2 mutations are linked to a hereditary, life-long risk of breast cancer and ovarian cancer. The National Cancer Institute reports that carriers of the BRCA gene are five times more likely to develop breast cancer than those without the mutations.
The study was designed to determine whether women with BRCA mutations experienced earlier onset of menopause than women unaffected by the BRCA gene. Researchers looked at nearly 400 women with BRCA gene mutations in northern California and compared their menopause onset to 765 women in the same region who did not have the mutation.
Study findings revealed that BRCA carriers were likely to enter menopause on average at the age of 50, compared to age 53 for non-carriers. Women with the abnormal gene who smoked 20 or more cigarettes a day experienced the onset of menopause at an average age of 46.
Infertility and early menopause
Early onset of menopause reduces a woman’s reproductive window and could possibly lead to a higher risk of infertility. Because many women with the mutation seek to reduce their risk of cancer by undergoing prophylactic surgery to remove their breasts and ovaries, study researchers recommend that BRCA carriers consider fertility counseling along with other medical treatments.
“Our findings show that mutation of these genes has been linked to early menopause, which may lead to a higher incidence of infertility,” Mitchell Rosen, MD, senior study author and associate professor in the University of California, San Francisco (UCSF) Department of Obstetrics and Gynecology and Reproductive Services, said in a news release.
“This can add to the significant psychological implications of being a BRCA1/2 carrier and will likely have an impact on reproductive decision-making,” added Rosen.
More research needed
The authors acknowledge that while their study points to a possible increased risk of infertility for women carrying the BRCA gene, further research in this area is needed. They also said in a news release that the study data regarding the age of natural menopause is limited because women with the mutation are frequently counseled to undergo risk-reducing surgery after they complete childbearing.
“Women with the mutation are faced with challenges in reproductive choices,” said study co-author Lee-may Chen, MD, a professor in the UCSF Department of Obstetrics and Gynecology and Reproductive Services.
“These data may help women understand that their childbearing years may be even more limited by earlier menopause, so that they can make decisions about their reproductive choices and cancer risk-reducing surgery,” added Chen.