Menopause and Metabolic Syndrome Prof. Sunila Khandelwal

Metabolic Syndrome An Epidemic and increasing worldwide Met S is a rising disease entity, still remains under diagnosed. 1.5‑2 times more common in women than in men. May develop in women in their menopausal transition years . More common over the age of 55 years with significant rise in risk factors during postmenopausal phase. Higher in Asian than Caucasian women, resulting in an enormous health, social and economic burden which is threatening to overwhelm the health care systems. LejskovaM etal,Climacteric 2011;13:83-91

Learning objective Highlight the prevalence of MetS. Identify reasons and the key metabolic issues based on recent research. Discuss updated guidelines and preventive strategies. Focus on aggressive early therapy for achieving targets. Clinicians should increase their awareness of the metabolic derangements associated with the syndrome, Consider them when weighing MHT options and also while considering management of individual parameters of syndrome.

Challenge is to understand its pathogenesis and to identify effective measures to prevent it either at the population level or at the individual level in any of the country / region. What are the key metabolic issues in women? Why should we focus on aggressive early therapy? How should we achieve targets?

Menopause & Metabolic Syndrome Characterized by clustering of metabolic conditions, Menopause itself contributes to the development of this syndrome

LINKED METABOLIC ABNORMALITIES RESULTING CLINICAL CONDITION Impaired glucose handling/insulin resistance Atherogenic dyslipidaemia Endothelial dysfunction Prothrombotic state Hemodynamic changes Proinflammatory state Excess ovarian testosterone production Sleep-disordered breathing Type 2 diabetes Essential hypertension Polycystic ovary syndrome (PCOS) Non-alcoholic fatty liver disease Cardiovascular Disease (Myocardial Infraction (MI), peripheral vascular disease (PVD), Stroke) Cancer (Breast, Colorectal, Liver) Obstructive Sleep apnoea Adverse metabolic changes occurring at menopause transition as a consequence of declining of ovarian sex steroids, increases the risk of CVD and stroke 3 times, DM type II 5 times