Underweight women are at an increased risk for early menopause, which can lead to increased risk for heart disease, osteoporosis, dementia and death, a large-scale study published in Human Reproduction has found.

Women with a body mass index under 18.5 are at a 30 percent increased risk of early menopause, the New York Times reported. Those with a BMI between 18.5 and 22.4—the standard healthy, “normal” range—didn’t record a significantly increased risk, according to the research, and neither did very obese women.

Of the nearly 80,000 women included in the study, 2,804 said they went through natural menopause before age 45.

“Underweight women may want to discuss the findings with their doctors,” lead author Kathleen L. Szegda told the New York Times.

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