leading to a decrease in estrogen and an increase in follicle-stimulating hormone (FSH). Menopause is thought to make women more susceptible to heart disease because it usually develops 10 years later than men, and the risk increases after menopause.
Previous studies have shown that menopause is linked to heart disease-promoting levels of metabolites, but this study is the first to link this change to changes in sex hormones. female. Metabolic changes are partially ameliorated by hormone replacement therapy (HRT).
Study author Dr. Eija K. Laakkonen of Jyvskyl University, Finland said: “Menopause is inevitable but negative metabolic changes can be mitigated by eating a healthy diet. and physical activity.
In particular, women should pay attention to the quality of fats in their diet and get enough exercise to maintain cardiovascular function. HRT is an option that women should discuss with health care providers at this point in their lives.
What changes occur in metabolite levels during the menopausal transition?
The analysis included 218 premenopausal women who did not use HRT at baseline. Levels of 180 metabolites (lipids, lipoproteins, and amino acids) and two hormones (estradiol and FSH) were obtained from blood samples at baseline and every three to six months through the early postmenopausal period. terrible.
Menopause status was assessed using a menstrual diary and blood FSH levels.
Soon after menopause
was defined as no period for more than six months and elevated FSH levels on at least two consecutive occasions. A total of 35 women (15%) started HRT during the study.
Dr Laakkonen explains: “Our study investigated whether hormonal changes during menopause modulate the metabolite structure measured in blood samples taken before and after menopause. Because the menopausal transition, i.e. a time of fluctuating hormone levels and menstrual irregularities, varies greatly from person to person, the timelines for assessment have been individualized. “
The researchers performed detailed statistical analyzes to determine what changes occurred in metabolite levels during the menopausal transition and whether these changes were related to sex hormone levels or not. They also examined whether the trajectories of metabolites differed between HRT users and nonusers.
The mean age at baseline was 51.7 years and the mean follow-up was 14 months.
Menopause was associated with a statistically significant change in the levels of 85 metabolites.
An exploratory analysis found that menopausal hormonal changes directly explained the change in 64 of 85 metabolites, with effect sizes ranging from 2.1% to 11.2%. These include low-density lipoprotein (LDL) cholesterol, triglycerides, fatty acids, and amino acids.
The analyzes were adjusted for age at baseline, duration of follow-up, education level, smoking status, alcohol use, physical activity, and diet quality. A second exploratory analysis found that HRT was associated with increased high-density lipoprotein (good) cholesterol and decreased LDL (bad) cholesterol.
Dr. Laakkonen said: “This study links hormonal changes during menopause with metabolic changes that cause heart disease. Previous studies did not confirm menopausal status with measurements. hormone, which means that they cannot distinguish menopausal effects from aging.Our results should be interpreted with caution, as sex hormone and HRT associations have been found in the fractions. exploratory and needs to be confirmed.”
She added: “Regarding HRT, it is not possible to draw very firm conclusions based on our observational study alone because the number of women who started treatment was small and the drug was not controlled. Our findings indicate that initiating HRT early in menopause, i.e. During the menopausal transition, provides the greatest cardiovascular protection.Women considering HRT should discuss this with their healthcare professional. their health care because there are many options and some potential contraindications such as a history of cancer or stroke should be considered.”