Changes in sex hormones during menopause increase levels of bad cholesterol, according to a study published in the European Journal of Preventive Cardiology, a publication of the European Society of Cardiology. According to researchers from Jyväskylä University, Finland, this increases the risk of cardiovascular disease in women going through menopause.
Most women go through menopause between the ages of 48 and 52. This leads to a decrease in estrogen levels and an increase in follicle-stimulating hormone (FSH). Researchers already know that menopause predisposes women to heart disease, but this study shows for the first time that this is due to a shift in female sex hormones. These transformations have been partially blocked by the use of hormone replacement therapy (HRT).
Study author Dr. Iga K. In particular, women should pay attention to the quality of fats in their diet and get enough exercise to maintain cardio-respiratory fitness. HRT is an option that women should discuss with their health care providers at this point in their lives.”
The study included 218 perimenopause women who were not using HRT. The team measured levels of 180 compounds, including cholesterol, lipoproteins and lipids, as well as estradiol and FSH at the start of the study and then every 3-6 months until early menopause. Menopause was assessed using menstrual diaries and serum FSH levels. Early postmenopause was defined as no periods for six months and high levels of FSH on two consecutive measurements. During the study, 35 women started HRT.
Our study investigated whether the hormonal change of menopause modifies the metabolite profile measured in blood samples taken before and after menopause. “Because the menopausal period, that is, the time with changing hormone levels and irregular menstruation, varies greatly from person to person, the time points for assessment were individualized,” said Dr. Lakkonen.
The results showed that menopause was associated with a significant change in 85 of all the metabolites measured, including low-density lipoprotein (LDL) cholesterol (the “bad” cholesterol), triglycerides, and fatty acids. Crucially, the researchers showed that these changes were mainly caused by changes in sex hormones. In contrast, women taking HRT had higher levels of high-density lipoprotein (“good”) cholesterol and lower levels of low-density lipoprotein cholesterol.
This study links hormonal changes during menopause with metabolic changes that promote heart disease. Previous studies have not confirmed menopause with hormone measurements, which means they cannot differentiate between the effects of menopause and old age,” said Dr. Lakkonen.
Regarding HRT, very strong conclusions cannot be drawn based on our observational study only because the number of women who started treatment was small and the type of medication was not controlled. However, our findings suggest that initiation of HRT early in menopause, that is, during the transition to menopause, provides the greatest cardioprotective effect. Women considering HRT should discuss it with their healthcare professional because there are many options and some potential contraindications such as a history of cancer or stroke that need to be considered.”
Karppinen JE, Törmäkangas T, Kujala UM, et al (2022) Menopause modulates metabolism: evidence from a prospective cohort study. Eur J Ex Cardiol. doi: 10.1093/eurjpc/zwac060