Relative androgen excess and increased cardiovascular risk after menopause: a hypothesized relation

Area of Science:

• Endocrinology
• Cardiovascular Medicine
• Women's Health

Background:

• Estrogen's role in menopause and cardiovascular disease (CVD) is well-studied.
• Androgen's influence on CVD risk in aging women is less understood.
• Estrogen and androgens may have opposing effects on CVD risk.

Purpose of the Study:

• To investigate the role of androgens in predicting CVD risk in women over 50.
• To propose a hormonal milieu framework (prepause, interpause, postpause) for understanding hormone-CVD associations.
• To highlight the potential significance of the interpause phase and relative androgen excess.

Main Methods:

• Hypothesized three distinct hormonal phases: prepause, interpause, and postpause.
• Defined interpause as the period from late perimenopause until approximately age 55.
• Focused on relative androgen excess during the interpause phase as a potential CVD risk factor.

Main Results:

• Relative androgen excess during the interpause phase may be a stronger predictor of CVD risk than estrogen levels alone.
• The duration of the interpause phase might be an independent risk factor for CVD.
• This hormonal hypothesis offers a new perspective on hormone-cardiovascular disease links.

Conclusions:

• Relative androgen excess during the interpause phase warrants further investigation as a CVD risk factor in postmenopausal women.
• This hypothesis may inform clinical and epidemiological research on hormone replacement therapy (HRT) for CVD prevention.
• Understanding these hormonal shifts is crucial for optimizing HRT strategies in aging women.