Menopause Has Negative Effects on Women's Cholesterol

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As women reach menopause, they may experience changes in their cholesterol levels – particularly LDL cholesterol - per new research published in the December 15-22 issue of the Journal of the American College of Cardiology.

Karen Matthews, professor at the University of Pittsburgh and the study’s lead author, analyzed data from the Study of Women’s Health Across the Nation (SWAN) that followed 1054 American women since 1996. The main goal was to better understand the changes women experience during their lifespan. One major change is menopause, that typically occurs around the age of 50 when estrogen production is reduced and menstruation ceases.

The women were approximately 47 years old at baseline, and had their natural final menstrual period approximately 3 years into the study. The final menstrual period, perimenopause, was defined as 12 consecutive months without a period.

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Previous studies have shown that a woman’s risk for cardiovascular problems increases after menopause, but were not sure if the risk was due to hormonal changes (estrogen appears to be protective against cardiovascular disease) or to age-related changes. The risk increases regardless of ethnic background and appear to be a fairly uniform response to menopause.

Matthews and colleagues found that in the year before and after the final menstrual period, total cholesterol increases due to a rise in LDL cholesterol and apolipoprotein B, the protein carrier for LDL cholesterol. LDL increased about 10.5 points, or 9%. Other cardiovascular risk factors, such as insulin, C-reactive Protein, and systolic blood pressure, also rose during the study, but at a steady state more indicative of age-related changes.

"The changes don't look large, but given that the typical woman lives several decades after menopause, any adverse change becomes cumulative over time," said Vera Bittner MD, MSPH of the University of Alabama at Birmingham, in an accompanying editorial. "If somebody had cholesterol levels at the lower ranges of normal, the small change may not make a difference. But if somebody's risk factors were already borderline in several categories, this increase may tip them over the edge and put them in a risk category where treatment may be beneficial."

As women reach the age of menopause, they should focus on lifestyle factors that can further increase cholesterol and cardiovascular disease, such as an appropriate diet, smoking cessation, and adequate physical activity. A study in the same journal, for example, found that a modest weight loss, just 22 pounds, in obese adults, just 22 pounds, can improve the heart muscle and blood vessel structure and function.

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