Menopause and increased risk of visceral fat formation
Metabolic changes during menopause inclthey require an increase in the central redistribution of adipose tissue. This phenomenon is due to a decrease in energy expenditure, especially BMR (basal metabolism). Women's metabolism slows down during this period, and this is associated with an increased risk of storing excess energy in fat tissue and also an increased risk of muscle tissue loss. Fat begins to center, i.e. accumulate in the waist area, and the representation of dangerous visceral fat increases. [1]
Centering obesity can be easily influenced by monitoring energy intake and adjusting the percentage representation of macronutrients. Ideally, menopausal women should prioritize high-quality protein over carbohydrates. Thanks to the higher representation of proteins in the diet, it is also possible to prevent osteoporosis and loss of muscle mass. Last but not least, they should increase energy expenditure through physical activities.
Menopause and increased risk of diabetes mellitus II. type
According to expert studies, menopause is one of the other risk factors for the development of DM II. type. During menopause, there is a malfunction in the secretion of insulin and also a reduced sensitivity of cells to insulin. Women who have other associated risk factors of metabolic syndrome, such as high blood pressure, higher waist circumference, higher BMI (Body Mass Index), and dyslipidemia (increased level of blood fats), are at a much higher risk of DM II. type than women without these risk factors. Here, we are all the more aware of how important it is to maintain a healthy weight throughout life and have a balanced diet. According to an expert article published in EMAS – clinical guide, menopausal hormone therapy (MHT) could have a beneficial effect on glucose metabolism in women with developed diabetes mellitus II. type, as well as in women without DM II. type, while MHT can develop DM II. type zoom out. [2]
Menopause and osteoporosis
Osteoporosis is widespread in older women after menopause, mainly due to the lack of estrogen, which subsequently increases the risk of fractures, which are associated with significant morbidity and mortality. Risk factors for postmenopausal osteoporosis are advanced age, genetics, smoking, too low a BMI, and many diseases and medications that impair bone health.
Non-pharmacological measures of menopause include proper nutrition (especially adequate intake of protein, calcium, and vitamin D), regular physical activity, avoidance of smoking, and excessive alcohol consumption. These recommendations are suitable for all women.
For women with a high risk of osteoporosis, who are going through menopause and at the same time have already been diagnosed with low bone density and have other risk factors, it is recommended to include MHT again, which improves bone metabolism. [3]
Menopause and depression
Menopause and the associated loss of reproductive capacity can be a risk period for the development of depression. According to several studies, there is a link between menopause and an increased incidence of depression symptoms. For a woman, this period can be very stressful, not only because the unpleasant symptoms of menopause appear, which often complicate women's lives, but also because the woman realizes that she is getting older. [4]
Menopause and cardiovascular disease
Cardiovascular diseases (CVD) are the leading cause of morbidity and mortality in men and women worldwide. Women are partially protected from CVD by the action of estrogens, so after menopause and the loss of hormonal effects, the differences in CVD diminish and women are at risk of CVD just like men. The risk of CVD is higher in women who have developed metabolic syndrome at the same time.
Although there is no doubt that MHT effectively alleviates the unpleasant symptoms of menopause, the protection against CVD mediated by replacement therapy is maximal if treatment is started in the absence of signs of atherosclerosis or metabolic syndrome.
Non-pharmacological measures, such as adequate exercise, smoking cessation, and proper nutrition, continue to be the most effective means of combating CVD. [5]
RESOURCES:
[1] Takahashi, T.A., & Johnson, K.M. (2015). Menopause. The Medical Clinics of North America, 99(3), 521–534. https://doi.org/10.1016/j.mcna.2015.01.006
[2] Slopien, R., Wender-Ozegowska, E., Rogowicz-Frontczak, A., Meczekalski, B., Zozulinska-Ziolkiewicz, D., Jaremek, J.D., Cano, A., Chedraui, P., Goulis, D.G., Lopes, P., Mishra, G., Mueck, A., Rees, M., Senturk, L.M., Simoncini, T., Stevenson, J.C., Stute, P., Tuomikoski, P., Paschou, S.A., Anagnostis , P., … Lambrinoudaki, I. (2018). Menopause and diabetes: EMAS clinical guide. Maturitas, 117, 6–10. https://doi.org/10.1016/j.maturitas.2018.08.009
[3] Management of osteoporosis in postmenopausal women: the 2021 position statement of The North American Menopause Society. (2021). Menopause (New York, N.Y.), 28(9), 973–997. https://doi.org/10.1097/GME.0000000000001831
[4] Vivian-Taylor, J., & Hickey, M. (2014). Menopause and depression: is there a link? Maturitas, 79(2), 142–146. https://doi.org/10.1016/j.maturitas.2014.05.014
[5] Leuzzi, C., Marzullo, R., & Modena, M.G. (2012). La menopause è un factoro di rischio per la cardiopatia ischemica? [Is menopause a risk factor for ischemic heart disease in women?]. Giornale italiano di cardiologia (2006), 13(6), 401–406. https://doi.org/10.1714/1073.11757
