Women have a rapid increase in metabolic syndrome (MetS) severity during menopausal transition and the severity decreases in postmenopause, according to a study in the Journal of the American Heart Association. 

Matthew J. Gurka, PhD, from the Department of Health Outcomes and Policy, College of Medicine, University of Florida in Gainesville, and colleagues assessed data from 1470 women from the Atherosclerosis Risk in Communities cohort who experienced a transition in menopausal status over 10 years. Menopausal status was divided into 3 groups: premenopausal, perimenopausal, and postmenopausal. The database included women 60 years and younger with no history of coronary heart disease or diabetes. The women were non-Hispanic white and non-Hispanic black.

Evidence used to determine whether MetS was evident in women through the menopausal transition included the 5 traditional MetS components: waist circumference, triglycerides, HDL cholesterol, systolic blood pressure, and fasting glucose. The task force also took into consideration the percentage of women taking hormonal replacement therapy, categorized as estrogen, estrogen plus progesterone, or none.

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At the start of the experiment, black participants had higher baseline waist circumference, systolic blood pressure, and glucose, had lower triglycerides, and were more likely to have hypertension. White participants were more likely to be taking hormonal replacement therapy. Women overall, and black women in particular, exhibited a more rapid rate of increase in MetS severity during the premenopausal and perimenopausal periods, compared with the postmenopausal period. The rate of increase in MetS severity during the premenopausal period was more rapid among black women than among white women.

Black women in particular had significant decreases in the rates of change during the postmenopausal period versus the premenopausal and perimenopausal periods. This most closely paralleled a rapid increase in triglyceride levels, as had been noted in previous studies of women during menopause. Also, the research team concluded that this higher prevalence of MetS appears to be related to the rapid progression of MetS severity in the years leading up to menopause and less because of progression after menopause.

The mechanisms behind the slower rate of progression of MetS severity after menopause could be related to changes in estrogen levels during the menopausal transition. Further research is needed to determine whether interventions during the menopausal transition such as diet, exercise, and medication could slow this rate of progression and lower the risk of CVD.


  1. Gurka MJ, Vishnu A, Santen RJ, DeBoer MD. Progression of metabolic syndrome severity during the menopausal transition. J Am Heart Assoc. 2016; doi: 10.1161/JAHA.116.003609.