For many women, infertility is often considered a challenge linked only to starting a family. But new research suggests it could be carrying a quieter message about future health as well.

A study published in the journal Menopause has found that women with a history of infertility, particularly unexplained infertility and endometriosis, may be more likely to enter menopause earlier than women without fertility problems. The findings raise fresh questions about how reproductive health in younger years may shape health decades later.

Researchers followed nearly 700 women over time, with roughly half having been diagnosed with primary infertility, a condition in which a woman has never been able to achieve pregnancy. They found that women with infertility experienced natural menopause about one year earlier on average than those without such a history.

The effect appeared even stronger among women with unexplained infertility, where doctors cannot identify a clear cause, and among those with endometriosis, a painful condition in which tissue similar to the lining of the uterus grows outside it.

Infertility is far from rare. According to global estimates, one in six people experience infertility during their lifetime. In India, where parenthood often carries strong social and cultural expectations, the condition affects millions of couples and frequently leads to emotional, financial and psychological stress.

The new findings suggest that infertility may also offer clues about long-term health risks.

Menopause marks the natural end of menstrual cycles. While most women reach menopause around the age of 51, early menopause occurs before age 45 and has been linked to a higher risk of cardiovascular disease, along with osteoporosis—a condition that weakens bones—and neurocognitive disorders that can affect memory and thinking skills.

Previous studies investigating links between infertility and menopause produced mixed results. Many researchers suspected a connection, but the evidence remained inconsistent due to the frequent grouping of different causes of infertility. The latest study attempted to address that gap by examining specific infertility types separately.

Importantly, the researchers found no association between infertility and premature menopause, which occurs before age 40. The increased risk was limited to early menopause rather than very early menopause.

Scientists believe several biological factors may explain the relationship. Hormonal imbalances, genetic influences, inflammatory conditions such as endometriosis, and factors affecting the number and quality of eggs in the ovaries could potentially contribute to both infertility and earlier reproductive ageing.

The findings add to a growing body of evidence showing that reproductive health can serve as a window into overall health. Previous research has linked infertility with increased risks of cardiovascular disease and certain cancers, suggesting that fertility challenges may sometimes reflect broader biological processes occurring throughout the body.

“This study shows that women with primary infertility, specifically those with unexplained infertility or a history of endometriosis, were at risk for early menopause. Given that early menopause is linked to adverse long-term health consequences, these women may benefit from counselling that they are at risk of early menopause. This will allow them to monitor for early menopause and to seek treatment with hormone therapy, if indicated,” said Dr Stephanie Faubion, medical director of The Menopause Society.

Researchers say the message is not one of alarm but awareness. Women with a history of infertility may benefit from discussing menopause risks with their healthcare providers and seeking medical evaluations if they notice symptoms such as irregular periods, missed cycles, or hot flashes. As scientists continue to uncover links between fertility and long-term health, the study serves as a reminder that reproductive health is not just about having children—it may also offer valuable clues about a woman's future wellbeing.