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Understanding Metabolic Syndrome and Its Impact on Women During Perimenopause and Menopause

As women transition into perimenopause, a phase leading up to menopause characterized by hormonal fluctuations, they may experience various changes in their bodies. One significant concern during this time is the development of metabolic syndrome, a cluster of conditions that can increase the risk of serious health problems, including diabetes, hypertension, ischemic heart disease (IHD), and dementia.



What is Metabolic Syndrome?

Metabolic syndrome is not a single disease but rather a collection of risk factors that increase the likelihood of developing other health issues. These risk factors include:

1. Abdominal obesity: Excess fat around the waistline, often referred to as visceral fat.

2. High blood pressure: Elevated blood pressure levels, typically defined as 130/85 mm Hg or higher.

3. High blood sugar: Elevated fasting glucose levels, indicating insulin resistance or impaired glucose metabolism.

4. High triglyceride levels: Elevated levels of triglycerides in the bloodstream, a type of fat found in the blood.

5. Low HDL cholesterol:Decreased levels of high-density lipoprotein (HDL) cholesterol, often referred to as "good" cholesterol.

Having three or more of these risk factors qualifies as metabolic syndrome.



Perimenopause and Metabolic Changes

During perimenopause, women experience hormonal fluctuations, including decreases in estrogen levels. These hormonal changes can contribute to metabolic shifts, such as increased abdominal fat deposition, insulin resistance, and changes in lipid metabolism. As a result, perimenopausal women are at an increased risk of developing metabolic syndrome.


Consequences of Metabolic Syndrome

Metabolic syndrome sets the stage for several serious health conditions, including:

1. Diabetes: Insulin resistance, a hallmark of metabolic syndrome, can progress to type 2 diabetes if left untreated. Diabetes can lead to complications such as neuropathy, retinopathy, and cardiovascular disease.

2. Hypertension: Elevated blood pressure, another component of metabolic syndrome, increases the risk of heart disease, stroke, and kidney damage.

3. Ischemic Heart Disease (IHD): Metabolic syndrome is associated with an increased risk of coronary artery disease, heart attacks, and other cardiovascular events.

4. Dementia: Research suggests that metabolic syndrome may be linked to an increased risk of cognitive decline and dementia in later life, although the exact mechanisms are still being studied.


Prevention and Management

Fortunately, lifestyle modifications can help prevent or manage metabolic syndrome and its associated health risks. These include:

1. Healthy diet: Focus on a balanced diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats. Limit intake of processed foods, sugary beverages, and saturated fats.

2. Regular exercise: Engage in regular physical activity, including aerobic exercises, strength training, and flexibility exercises, to help improve insulin sensitivity, maintain a healthy weight, and promote cardiovascular health.

3. Weight management: Maintain a healthy weight or lose excess weight if necessary, as even modest weight loss can improve metabolic parameters and reduce the risk of metabolic syndrome-related complications.

4. Stress management: Practice stress-reducing techniques such as meditation, deep breathing exercises, or hobbies to help manage stress levels, which can impact metabolism and overall health.

5. Regular health screenings: Visit your healthcare provider regularly for check-ups and screenings to monitor blood pressure, blood sugar, cholesterol levels, and other metabolic parameters. Early detection and intervention can help prevent or delay the progression of metabolic syndrome and associated conditions.



6. Address your hormones and other perimenopause symptoms: As women go through menopause and their estrogen levels drop, another type of estrogen called estrone tends to go up. This increase happens partly because of a process in the body that turns testosterone into estrogen. When women have more fat around their bellies, which is common in menopause, their body makes more of this estrogen. This rise in estrone, along with the decrease in the main estrogen (17 B Estradiol), can lead to changes in how the body handles fats and sugar. This can make women more likely to have problems like high cholesterol, high blood sugar, and a bigger risk of heart disease.


For the nerd in every one of us. Here are the molecules involved in the process of estrone leading to belly fat.

1. 17β-estradiol: This is the main form of estrogen produced by the ovaries before menopause.

2. Estrone: Another form of estrogen, produced in peripheral tissues like adipose (fat) tissue.

3. Aromatase: An enzyme responsible for converting androgens testosterone into estrogens, including estrone.


The process involved is:

Aromatization: This is the process by which aromatase converts androgens (like testosterone) into estrogens (like estrone).


In menopausal women, adipose tissue, particularly visceral fat (fat around abdominal organs), becomes a significant source of aromatase activity. As a result, more testosterone is converted into estrone in the fat tissue, leading to increased levels of estrone in the body. This rise in estrone, along with the decrease in 17β-estradiol, contributes to hormonal changes and metabolic alterations associated with menopause. Typically, women notice a shift from their regular pear shape fat distribution to apple shape. We start to develop this roll of fat in our abdomen that will not shift. But if we reintroduce our own natural estrogen (17 B Estrodiol) in HRT, the body no longer requires aromatization to estrone and we start to lose the belly fat. Our efforts to live well and exercise are much easily rewarded because our body is not fighting against us.


In conclusion, metabolic syndrome is a significant health concern for women during perimenopause and beyond. By understanding the risk factors, consequences, and preventive measures associated with metabolic syndrome, women can take proactive steps to protect their health and well-being as they navigate the transition into menopause and beyond. It.

Know the why and address it!


By Dr Purity Carr

GP & Menopause Doctor

Harvey 6220 WA


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1 Comment


Unknown member
Apr 28

I find all this information fascinating! I always want to know what’s going on in my body and you explain it so well I can understand what it all means! Thankyou ☺️

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