High androgens in postmenopausal women and the risk for atherosclerosis and cardiovascular disease: the Rotterdam study
Open accessAbstract
Context: Polycystic ovary syndrome (PCOS) is closely linked to hyperandrogenism (HA). In PCOS, HA has been associated with metabolic disturbances that increase the risk for cardiovascular disease (CVD). Objective: To assess the association of high serum androgen levels, as a postmenopausal remnant of PCOS, with the prevalence of atherosclerosis and incidence of CVD in postmenopausal women. Design: The Rotterdam Study, a prospective population-based cohort study. Median follow-up was 11.36 years. Setting: General community. Participants: A total of 2578 women aged >55 years. Exclusion criteria were missing informed consent or follow-up data, perimenopausal status, and menopause by surgical intervention or at an unnatural age (age <40 or >62). Intervention: None. Main Outcomes and Measures: Linear, logistic, and Cox regression models assessed the association of top quartiles (P75) of serum testosterone, free androgen index (FAI), dehydroepiandrosterone, and androstenedione and sex hormone-binding globulin with coronary artery calcium, carotid intima-media thickness (IMT), pulse wave velocity, peripheral artery disease, and incidence of coronary heart disease (CHD), stroke, and CVD. Results: Mean age (standard deviation) was 70.19 (8.71) years, and average time since menopause was 19.85 (9.94) years. Highest quartile FAI was associated with higher pulse wave velocity (β [95% confidence interval (CI)], 0.009 [0.000 to 0.018]). Highest quartile dehydroepiandrosterone [β (95% CI), -0.008 (-0.015 to -0.001)] and androstenedione [β (95% CI), -0.010 (-0.017 to -0.003)] levels were associated with a lower IMT. We found no association between high androgen levels and incident stroke, CHD, or CVD. Conclusion: Postmenopausal high androgen levels were not associated with an elevated risk for CVD. Cardiovascular health in women with PCOS might be better than was anticipated.
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PCOS has been recognized recently as a lifelong disease affecting individuals into the postmenopausal years.
“PCOS has been recognized recently as a lifelong disease affecting individuals into the postmenopausal years.35, 36, 37, 38, 39”
From Increased Prevalence of Adverse Health Outcomes Across the Lifespan in Those Affected by Polycystic Ovary Syndrome: A Canadian Population Cohort (2024) · cites this paper as [37]
The Abstract (page unavailable) discusses a possible postmenopausal remnant of PCOS, and the Conclusions and implications report persistent high androgen levels after menopause. These passages support the point that PCOS-related features can extend into postmenopausal years, but they do not establish the broader claim that PCOS is recognized as a lifelong disease. (LLM, conf=0.82)
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References 33 · Cited by 126
Research works printed but not linked: 1
- Markopoulos MC, Kassi E, Alexandraki KI, Mastorakos G, Kaltsas G. Hyperandrogenism after menopause. Eur J Endocrinol. 2015;172(2):R79-R91.
- Authors
- Meun, C., Franco, O. H., Dhana, K., Jaspers, L., Muka, T., Louwers, Y., Ikram, M. A., Fauser, B. C. J. M., Kavousi, M., & Laven, J. S. E.
- Affiliations
- Erasmus MC (NL)
- University Medical Center Utrecht (NL)
- Corresponding author
- Meun, Cindy
- ORCID
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2018-02-01
- Volume
- 103
- Issue
- 4
- Pages
- 1622-1630
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W2789724545
- Cited by
- 126
- References
- 33
- Citations by year
- 2026: 6 · 2025: 19 · 2024: 11 · 2023: 19 · 2022: 9 · 2021: 19 · 2020: 19 · 2019: 13 · 2018: 11
- FWCI
- 16.56
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
- Funders
- European Commission
- ZonMw
- Nederlandse Organisatie voor Wetenschappelijk Onderzoek
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- hyperandrogenism, postmenopausal women, polycystic ovary syndrome, cardiovascular disease, atherosclerosis, free androgen index, serum testosterone, dehydroepiandrosterone, androstenedione, sex hormone-binding globulin, carotid intima-media thickness, coronary artery calcium, pulse wave velocity, peripheral arterial disease, coronary artery disease, stroke
- MeSH terms
- Aged, Aged, 80 and over, Androgens, Androstenedione, Calcium, Cardiovascular Diseases, Dehydroepiandrosterone, Female, Humans, Middle Aged, Risk Factors, Sex Hormone-Binding Globulin, Testosterone, Incidence, Prevalence, Postmenopause, Atherosclerosis, Carotid Intima-Media Thickness
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