Our study showed that the early onset of menopause is associated with an increased risk of cardiovascular disease and mortality. We agree with Hayes et al as well as Mascitelli and Goldstein that elevated iron levels observed after menopause can be a potential mechanism linking the early onset of menopause with adverse cardiometabolic health. Iron is one of the most abundant metals in the human body and is required as an essential cofactor in many important biological processes, such as oxygen transport, DNA synthesis, energy production, and regulation of cell growth and differentiation.