The Effect of Menopause on the Cardiovascular System
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Abstract
Menopause is the permanent cessation of menstruation for 12 consecutive months without any underlying pathological cause. This occurs due to ovarian follicular atresia, which leads to the cessation of estrogen production. The menopausal transition begins 5 to 10 years before menstruation ceases. During menopause, estrogen levels decline, leading to biological changes in the body, such as an increase in total cholesterol, low-density lipoproteins (LDL), triglycerides, and apolipoprotein B, as well as a decrease in high-density lipoprotein (HDL), an increase in visceral fat, and the development of metabolic syndrome. Various characteristics of menopause have been evaluated in relation to cardiovascular disease (CVD) risk, including age at menopause onset, type and stage of menopause, endogenous estradiol levels, and menopause-related symptoms. These factors have been found to be associated with CVD risk, with the highest risk occurring in women with ovarian failure and relatively early menopause. Women with early menopause (aged 40–44 years) have a hazard ratio of 1.55 (95% CI: 1.38–1.73) for coronary artery disease events compared to women with menopause at age 50–54 years. Women with premature ovarian failure tend to have a shorter life expectancy compared to those who experience late menopause, primarily due to an increased risk of cardiovascular disease.
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References
Fasero M, Coronado PJ. Cardiovascular disease risk in women with menopause. J Clin Med 2025;14:3663.
Gatenby C, Simpson P. Menopause: Physiology, definitions, and symptoms. Best Pract Res Clin Endocrinol Metab 2024;38:101855.
Monteleone P, Mascagni G, Giannini A, Genazzani AR, Simoncini T. Symptoms of menopause—global prevalence, physiology and implications. Nat Rev Endocrinol 2018;14:199–215.
Chang JG, Lewis MN, Wertz MC. Managing menopausal symptoms: common questions and answers. Am Fam Physician 2023;108:28–39.
Crandall CJ, Mehta JM, Manson JE. Management of menopausal symptoms: a review. Jama 2023;329:405–20.
El Khoudary SR, Aggarwal B, Beckie TM, Hodis HN, Johnson AE, Langer RD, et al. Menopause transition and cardiovascular disease risk: implications for timing of early prevention: a scientific statement from the American Heart Association. Circulation 2020;142:e506–32.
Rodriguez de Morales YA, Abramson BL. Cardiovascular and physiological risk factors in women at mid-life and beyond. Can J Physiol Pharmacol 2024;102:442–51.
Xiang D, Liu Y, Zhou S, Zhou E, Wang Y. Protective effects of estrogen on cardiovascular disease mediated by oxidative stress. Oxid Med Cell Longev 2021;2021:5523516.
Abramson BL, Black DR, Christakis MK, Fortier M, Wolfman W. Guideline No. 422e: menopause and cardiovascular disease. J Obstet Gynaecol Canada 2021;43:1438–43.
Raj A, Chakole S, Agrawal S, Gupta A, Khekade H, Prasad R, et al. The impact of menopause on cardiovascular aging: a comprehensive review of androgen influences. Cureus 2023;15.
Torosyan N, Visrodia P, Torbati T, Minissian MB, Shufelt CL. Dyslipidemia in midlife women: approach and considerations during the menopausal transition. Maturitas 2022;166:14–20.
Yao F, Niu J, Zheng Y, Li Q, Lu X. Body composition and dyslipidemia in postmenopausal medical workers: a cross-sectional study. BMC Womens Health 2026;26:77.
Li S, Tan I, Atkins E, Schutte AE, Gnanenthiran SR. The pathophysiology, prognosis and treatment of hypertension in females from pregnancy to post-menopause: a review. Curr Heart Fail Rep 2024;21:322–36.
Gersh FL, O’Keefe JH, Lavie CJ, Henry BM. The renin-angiotensin-aldosterone system in postmenopausal women: the promise of hormone therapy. Mayo Clin. Proc., vol. 96, Elsevier; 2021, p. 3130–41.
Genazzani AD, Petrillo T, Semprini E, Aio C, Foschi M, Ambrosetti F, et al. Metabolic syndrome, insulin resistance and menopause: the changes in body structure and the therapeutic approach. Gynecol Reprod Endocrinol Metab 2024;4:86–91.
Munshi A, Garg R. Obesity and Menopause: Redefining Obesity–New Guidelines. J Midlife Health 2025;16:1–5.
Opoku AA, Abushama M, Konje JC. Obesity and menopause. Best Pract Res Clin Obstet Gynaecol 2023;88:102348.
Brzozowska M, Lewiński A. Changes of androgens levels in menopausal women. Menopause Rev Menopauzalny 2020;19:151–4.
Zhao D, Guallar E, Ouyang P, Subramanya V, Vaidya D, Ndumele CE, et al. Endogenous sex hormones and incident cardiovascular disease in post-menopausal women. J Am Coll Cardiol 2018;71:2555–66.
El Khoudary SR. Gaps, limitations and new insights on endogenous estrogen and follicle stimulating hormone as related to risk of cardiovascular disease in women traversing the menopause: a narrative review. Maturitas 2017;104:44–53.
Ryczkowska K, Adach W, Janikowski K, Banach M, Bielecka-Dabrowa A. Menopause and women’s cardiovascular health: is it really an obvious relationship? Arch Med Sci AMS 2022;19:458.
Ramirez MF, Honigberg M, Wang D, Parekh JK, Bielawski K, Courchesne P, et al. Protein biomarkers of early menopause and incident cardiovascular disease. J Am Heart Assoc 2023;12:e028849.
Manrique-Acevedo C, Chinnakotla B, Padilla J, Martinez-Lemus LA, Gozal D. Obesity and cardiovascular disease in women. Int J Obes 2020;44:1210–26.
Powell-Wiley TM, Poirier P, Burke LE, Després J-P, Gordon-Larsen P, Lavie CJ, et al. Obesity and cardiovascular disease: a scientific statement from the American Heart Association. Circulation 2021;143:e984–1010.