Menopause-associated risk of cardiovascular disease

Area of Science:

• Cardiology
• Endocrinology
• Women's Health

Background:

• Cardiovascular disease (CVD) is a significant concern for menopausal women due to hormonal changes.
• These changes contribute to risk factors like visceral obesity, dyslipidemia, glucose dysregulation, NAFLD, and hypertension.
• Early menopause (<45 years) is independently linked to increased CVD events.

Purpose of the Study:

• To evaluate the role of menopausal hormone therapy (MHT) in mitigating CVD risk factors in menopausal women.
• To assess the optimal timing and type of MHT for cardiovascular health.
• To clarify MHT's contraindications and its specific role in CVD prevention.

Main Methods:

• Review of existing literature on menopause, CVD risk factors, and menopausal hormone therapy.
• Analysis of the impact of different MHT formulations (transdermal estrogens, specific progestogens) on CVD risk markers.
• Examination of clinical guidelines regarding MHT initiation and contraindications.

Main Results:

• Menopausal hormone therapy (MHT) can improve key CVD risk factors.
• Transdermal estrogens are preferred due to no increase in triglycerides and lower VTE risk.
• MHT may reduce CVD morbidity and mortality if initiated early post-menopause (<60 years or within 10 years of LMP).
• MHT is crucial for women with premature ovarian insufficiency (POI) until average menopause age.
• MHT is contraindicated in women with a history of VTE.
• Breast cancer risk with MHT is generally low, influenced by progestogen type; micronized progesterone and dydrogesterone show lower risk.

Conclusions:

• MHT can effectively manage CVD risk factors associated with menopause.
• Early initiation of MHT in the postmenopausal period may offer cardiovascular benefits.
• MHT is not recommended solely for CVD prevention and has specific contraindications.
• The choice of progestogen in MHT influences breast cancer risk.