Hormone replacement therapy and lipoprotein changes during early menopause

Article Abstract:

Women who take hormones during or after menopause have different levels of blood lipoproteins (fats attached to proteins) than women who do not receive hormone therapy; in general, estrogen (a female hormone) affects lipoprotein levels in a manner that is related to a decreased risk for cardiovascular disease. Progestogens (other female hormone) may be added to the estrogen regimen to protect against cancer of the uterine lining (which is associated with estrogen use), but may adversely affect the risk for cardiovascular disease. To evaluate the effects of these two hormone treatments and of no hormone therapy at all, 211 postmenopausal or perimenopausal (undergoing menopause) women were studied. The subjects took oral estrogen (15 women), an estrogen-progestogen combination (39), or no hormones (157). They underwent blood pressure measurements and blood tests, and completed questionnaires regarding health behaviors (such as smoking, physical activity, alcohol use) on two occasions. The blood tests were analyzed to obtain information regarding blood glucose (sugar), and levels of lipoprotein and triglyceride (another form in which fats are transported). Results showed that the two hormone-treated groups had higher levels of high density lipoprotein cholesterol (HDL, which is related with a lower risk of cardiovascular disease), higher levels of apolipoproteins AI and AII (the protein parts of lipoproteins), and lower levels of low density lipoprotein cholesterol (LDL, which is related with an increased cardiovascular disease risk). Menopausal women who did not receive hormone therapy had a much smaller increase in apolipoprotein AI, and a greater increase in LDL cholesterol. Women who were given estrogen or the combination hormone treatment had greater increases in triglyceride levels than non-users; they also had a greater increase in blood pressure. (Both factors are associated with a higher risk of cardiovascular disease.) However, compared with non-users, the overall trend for estrogen users in either group was positive. (Consumer Summary produced by Reliance Medical Information, Inc.)

Cardiovascular diseases, Physiological aspects, Hormone therapy, Lipoproteins, Blood lipoproteins

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Weight gain at the time of menopause

Article Abstract:

The increased risk of coronary heart disease (CHD) after menopause is one of the most common reasons why older women begin estrogen replacement therapy, which involves taking estrogen to replace that which is produced in younger women. However, it is possible that the increased incidence of CHD in postmenopausal women is related to weight gain at this time in life, not to changes in hormone levels. To test this hypothesis, and to determine what caused the changes in CHD risk factors and which women were at greatest risk, 485 premenopausal women between the ages of 42 and 50 were studied in 1983 or 1984, and again in 1987. The data provide information on the weight changes that occur among women at the time of menopause, and provide evidence that these changes are related to changes in CHD risk factors. The women gained an average of almost five pounds during the three-year period, with no difference between the women who had not reached menopause and those who had. The women who took hormone therapy gained more weight, as did black women and women who lived alone or decreased their activity levels. Weight gain was associated with increases in the levels of total cholesterol, triglycerides, blood pressure, and insulin. Increases in low-density-lipoprotein (LDL) cholesterol may be a result of weight gain, but the LDL levels, when analyzed by weight change category, differed only according to menopausal status. Even mild to moderate obesity has been found to increase the risk of heart disease in middle-aged women, and prevention of weight gain or loss of weight may lessen the increase in CHD risk for these women. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Complications and side effects, Demographic aspects, Overweight persons, Obesity, Middle aged women

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Menopause and risk factors for coronary heart disease

Article Abstract:

The incidence of coronary artery disease (CAD) is higher among postmenopausal women and women who have undergone oophorectomy (removal of ovaries) than among premenopausal women of similar ages. The cases of 541 premenopausal women between the ages of 42 and 50 were studied over a five-year period to determine changes in coronary risk factors attributable to natural menopause. During the course of the study, 69 women stopped menstruating for at least 12 months and 32 women received hormone-replacement therapy after stopping menstruation completely. Significantly higher levels of total cholesterol, triglycerides, apolipoprotein A-I and A-II were found in the menopausal women who did not receive hormone therapy. Changes in high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol levels were attributed to natural menopause. LDL cholesterol levels were twice as high in menopausal women than in their controls, while HDL cholesterol levels were lower in naturally menopausal women. The results indicate that natural menopause is responsible for an increase in LDL cholesterol levels and a decrease in HDL cholesterol levels, which may lead to an increased risk of CAD.

High density lipoproteins, Low density lipoproteins

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