Some women who manage to maintain a healthy weight and have “good” numbers for their blood pressure, cholesterol, and blood sugar for most of their life may find this is no longer the case after they reach menopause. A study published in June 2020 in the journal Menopause suggests that their chance of developing so-called metabolic syndrome, when many of these things are too high, climbs as much as 38 percent after menopause.
Researchers examined data on 12,611 Canadian women ranging in age from 45 to 85 years old, including 10,035 women who had reached menopause and 2,576 who had not. The postmenopausal women were more than a decade older, with an average age of 65, compared with 51 among premenopausal women.
RELATED: 10 Ways to Beat Menopausal Belly Fat
Even after researchers accounted for age at menopause and whether women used hormone therapy (HT) for menopausal symptoms — two factors that can independently impact the risk of several conditions involved in metabolic syndrome — researchers found that postmenopausal women were still 10 percent more likely to develop metabolic syndrome compared with premenopausal women.
Menopause: The Definition and the Diagnosis
Menopause occurs when a woman stops menstruating, and it marks the permanent end of fertility. The diagnosis is made in retrospect, after a woman has not had a menstrual period for 12 months in a row.
The transition from being premenopausal to post-menopausal can last up to 10 years. The lead-up to “the change” is called perimenopause; the after time is post-menopause. During the transition, the levels of estrogen and other hormones drop off.
RELATED: Perimenopause vs. Menopause: What’s the Difference?
The Practical Implications of Increased Metabolic Syndrome Risk
“This greater risk raises the need for an increase in emphasis on protective interventions, such as healthier eating and increased exercise among women in menopause,” says Mark DeBoer, MD, a researcher at the University of Virginia in Charlottesville, who wasn’t involved in the study.
The study wasn’t a controlled experiment designed to prove that menopause directly causes metabolic syndrome. The results also may not be generalizable to the entire population of Canada because the women in the study were predominately of European ancestry and didn’t reflect the country’s much more diverse, multiethnic population, the study team notes.
Menopause Has Been Linked to Metabolic Syndrome Before
Studies conducted more than a decade ago in the United States and Asia found a similar link between menopause and metabolic syndrome.
Research published in JAMA Internal Medicine followed 929 American women for nine years, starting when they were premenopausal and didn’t have diabetes or metabolic syndrome. All of them went through menopause during the study; after their menopausal transition, women were 24 percent more likely to develop metabolic syndrome than they were before.
Other research published in Menopause examined data on 618 premenopausal and 384 postmenopausal women in South Korea. Postmenopausal women were almost 3 times more likely to develop metabolic syndrome, this study found.
What’s striking in the new Canadian study is that fewer women had obesity or were overweight than in some previous studies linking menopause to metabolic syndrome, says Robert Eckel, MD, a professor emeritus at the University of Colorado Anschutz Medical Campus and past president of the American Heart Association.
Hormonal Shift Means Body Composition Shift
That’s because the most important factor contributing to the increased risk of metabolic syndrome after menopause is a shift in body composition that involves a higher percentage of fat tissue, a decline in lean muscle tissue, and a redistribution of fat around the abdomen, says Dr. Eckel, who wasn’t involved in the study.
“This is partly but not entirely due to relative estrogen deficiency,” Eckel says.
What Hormonal Changes Mean For Overall Health
Women reach menopause when they stop menstruating, which typically happens when they’re 45 to 55 years old. During this transition, the ovaries make less of the reproductive hormones estrogen and progesterone, a reduction that can trigger symptoms like hot flashes, vaginal dryness, insomnia, mood swings, and urinary tract infections (UTIs).
After menopause women have an increased risk of a variety of health conditions — including several that contribute to metabolic syndrome. Among other things, menopause is associated with an increased risk of heart disease, osteoporosis, sexual dysfunction, and weight gain, according to the Mayo Clinic.
RELATED: 9 Steps Proven To Help You Lower Your BMI
Fat Migrates to Middle of the Body as Estrogen Levels Decline
The dramatic drop in estrogen levels at the time of menopause can also be accompanied by an increase in so-called visceral fat, a type of fat stored within the abdomen, Dr. DeBoer says. Visceral fat is harder to get rid of than subcutaneous fat, the kind stored right under the skin that’s more common before menopause.
“This central or visceral fat is more metabolically active and produces a higher risk for metabolic syndrome and cardiovascular disease,” DeBoer adds.
RELATED: 12 Women Over 60 Who Enable and Inspire Wellness
Metabolic Syndrome: How to Define It, Understand It
Women are typically diagnosed with metabolic syndrome when they have at least three of these five conditions, according to the National Institutes of Health (NIH):
Having metabolic syndrome increases the risk of heart disease, diabetes, stroke, and other health problems, according to the NIH.
“It’s pretty clear than women across the globe have higher cardiovascular risk starting in midlife, and this relates to a number of factors, including weight gain, higher rates of obesity, higher blood pressure and more adverse lipid profiles,” says Stephanie Faubion, MD, medical director of the North American Menopause Society and director of the Mayo Clinic Center for Women’s Health.
A Healthy Lifestyle Is Key to Preventing Midlife Medical Problems
“Women should anticipate these midlife changes and double down on avoiding weight gain and increasing exercise,” says Dr. Faubion, who wasn’t involved in the Canadian study.
Cutting calories and avoiding simple carbohydrates like white bread and refined grains and sweets can help women maintain a healthy weight in midlife, and so can getting more exercise, Faubion advises.
Lifestyle changes like this can help prevent or postpone some of the more serious health problems that can develop with metabolic syndrome, including events like heart attacks and strokes.
RELATED: How Denise Austin Torches Post-Menopause Belly Fat (and Other Unwanted Flab)
What to Do if You Are Diagnosed With Metabolic Syndrome
There’s a lot women can do to reverse conditions that contribute to metabolic syndrome — or to at least stop these conditions from getting worse, according to the Mayo Clinic:
- Get at least 30 minutes a day of exercise like brisk walking, even if it’s broken up into several short bursts throughout the day.
- Lose weight — a 7 to 10 percent reduction in weight can help lower blood pressure and blood sugar.
- Eat a heart-healthy diet, such as a Mediterranean diet or the Dietary Approaches to Stop Hypertension (DASH) diet — this means lots of fruits, veggies, high fiber whole grains, and lean protein as well as limiting sugar, alcohol, salt, and saturated fats.
- Stop smoking.
- Reduce stress with activities like yoga, meditation, or exercise that boost your emotional health.
RELATED: 7 Fun Ways to Move at Midlife
