Metabolic Implications of Menopause

Polotsky, Hanah; Polotsky, Alex

doi:10.1055/s-0030-1262902

Cited by 254Menopause: Health Impacts and TreatmentsDiabetes, Cardiovascular Risks, and LipoproteinsEstrogen and related hormone effects

Metabolic Implications of Menopause

Polotsky, Hanah, Polotsky, Alex·2010·Seminars in Reproductive Medicine

DOI 10.1055/s-0030-1262902

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Abstract

The incidence of metabolic syndrome increases substantially during perimenopause and early menopause. Postmenopausal women are at a higher risk of hypertension, proatherogenic lipid changes, diabetes, and severe cardiovascular disease as compared with their premenopausal counterparts. Whether or not menopause has a causative contribution to the deteriorating metabolic profile that is independent of chronological aging has been a subject of many studies. Menopausal transition is associated with significant weight gain (2 to 2.5 kg over 3 years on average), which is not dissimilar to that in premenopausal women of like age. Concomitantly, there is an increase in abdominal adiposity and a decrease in energy expenditure, phenomena that have been postulated to explain the higher risk of metabolic syndrome and increases in cholesterol and triglycerides. Hypertension and diabetes become more prevalent with age and should be timely diagnosed and treated. Lifestyle changes including moderately decreased caloric intake and aerobic exercise could prevent proatherogenic changes and weight gain observed with aging. Accurate prediction of cardiovascular risk in midlife women is essential to help identify the subset of women who are likely to benefit from intensive management of metabolic risk factors. This review focuses on metabolic changes associated with menopausal transition, specifically alterations in weight, waist circumference, body fat distribution, energy expenditure, and circulating biomarkers including adipokines.

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The reduction in progesterone impacts the ratio of estradiol:progesterone, invoking an imbalance illustrated by anabolic resistance of muscle protein synthesis, insulin resistance, increased abdominal adiposity, decreased lean mass, a reduction in bone mineral density, and a decrease in energy expenditure.
“The reduction in progesterone impacts the ratio of estradiol: progesterone (E:P), invoking an imbalance, illustrated by anabolic resistance of muscle protein synthesis, insulin resistance, increased abdominal adiposity, decreased lean mass, a reduction in bone mineral density, and a decrease in energy expenditure [110,111].”
From International society of sports nutrition position stand: nutritional concerns of the female athlete (2023) · cites this paper as [110]

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Authors: Polotsky, H., & Polotsky, A.
Affiliations: Memorial Sloan Kettering Cancer Center (US)
Albert Einstein College of Medicine (US)
ORCID: Polotsky, Alex
Venue: Seminars in Reproductive Medicine
Publisher: Georg Thieme Verlag KG
Published: 2010-09
Volume: 28
Issue: 05
Pages: 426-434
ISSN: 1526-4564 (ISSN-L)
1526-8004
DOI: 10.1055/s-0030-1262902
OpenAlex: W1964510976
Cited by: 254
References: 0
Citations by year: 2026: 7 · 2025: 8 · 2024: 17 · 2023: 10 · 2022: 16 · 2021: 19 · 2020: 15 · 2019: 19 · 2018: 12 · 2017: 22 · 2016: 20 · 2015: 21 · 2014: 26 · 2013: 13 · 2012: 20
FWCI: 10.14
Type: journal article
Language: en
Open access: closed
Locations: Seminars in Reproductive Medicine (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Estrogen and related hormone effects
Keywords: menopause, metabolic syndrome, perimenopause, postmenopausal women, weight gain, abdominal fat, body fat distribution, energy expenditure, hypertension, diabetes mellitus, cardiovascular disease, atherosclerosis, lipid profile, cholesterol, triglycerides, adipokines, cardiovascular risk prediction, middle-aged women, lifestyle intervention, caloric restriction, aerobic exercise
MeSH terms: Energy Intake, Cardiovascular Diseases, Cholesterol, Diabetes Mellitus, Energy Metabolism, Female, Humans, Hypertension, Lipids, Male, Menopause, Obesity, Risk Factors, Triglycerides, Biomarkers, Weight Gain, Exercise, Incidence, Prevalence, Premenopause, Postmenopause, Metabolic Syndrome, Perimenopause, Abdominal Fat, Body Fat Distribution, Waist Circumference

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Metabolic Implications of Menopause

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