Assessment of the Risk of Metabolic Disorders during Menopause: A Literature Review
DOI:
https://doi.org/10.52340/spectri.2025.11.01.17Keywords:
menopause, metabolic disorders, insulin resistance, dyslipidemia, Georgia, STEPS studyAbstract
Background: Menopause is a natural biological transition characterized by a decline in estrogen production, leading to multiple metabolic alterations. Hormonal imbalance contributes to increased risk of insulin resistance, dyslipidemia, central obesity, and hypertension. Global and regional studies indicate that the prevalence of metabolic syndrome significantly rises during postmenopause. The WHO STEPS surveys (2016–2021) in Georgia revealed a notable increase in metabolic abnormalities among women aged 45–69, especially in urban areas.
Objective: To review the mechanisms and risk factors of metabolic disorders during menopause, highlighting global patterns and national evidence from Georgia.
Methods: A literature search was conducted across PubMed, Scopus, WHO, and Google Scholar databases (2019–2025) using the keywords menopause, metabolic syndrome, insulin resistance, dyslipidemia, postmenopausal women, and Georgia population. More than 60 peer-reviewed studies and WHO/IDF reports were analyzed.
Results: Hormonal decline during menopause triggers metabolic shifts that enhance the risk of cardiovascular diseases, type 2 diabetes, and obesity. The interplay of genetic, epigenetic, and behavioral determinants defines the risk magnitude, while physical inactivity and unhealthy diet remain the most prevalent modifiable factors.
Conclusion: Prevention of metabolic disorders in menopausal women requires early screening, targeted lifestyle interventions, and integration of metabolic risk assessment into national public health strategies.
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References
World Health Organization (WHO). Global Health Observatory Data Repository: Noncommunicable Diseases.Geneva: WHO; 2024.[1]
International Diabetes Federation (IDF). IDF Diabetes Atlas. 11th ed. Brussels: IDF; 2025.
Patel P, Patil S, Kaur N. Estrogen and Metabolism: Navigating Hormonal Transitions from Perimenopause to Postmenopause. J Midlife Health. 2025 Jul-Sep;16(3):247-256.
Shokri-Ghadikolaei A, Bakouei F, Delavar MA, Azizi A, Sepidarkish M. Effects of health coaching on menopausal symptoms in postmenopausal and perimenopausal women. Menopause. 2022 Oct 1;29(10):1189-95.
Gumpeny N, Gumpeny L, Gumpeny SR. Metabolic syndrome in menopause. Exploration of Endocrine and Metabolic Diseases. 2025 Sep 24;2:101440.
De Paoli M, Zakharia A, Werstuck GH. The role of estrogen in insulin resistance: a review of clinical and preclinical data. The American journal of pathology. 2021 Sep 1;191(9):1490-8.
World Health Organization. STEPS Georgia Report. Ministry of Internally Displaced Persons from the Occupied Territories, Labour, Health and Social Affairs of Georgia; 2016.
World Health Organization. STEPS Georgia Follow-up Survey. Ministry of Internally Displaced Persons from the Occupied Territories, Labour, Health and Social Affairs of Georgia; 2021.
Armocida B, Klepp KI, Onder G, Farrington JL, Granlund L, Takki M, Mikkelsen B, Cecchini M, Galea G, Rakovac I. Advancing Europe's non-communicable diseases agenda through cross-national collaboration: translating WHO-Europe findings into actionable strategies. The Lancet Regional Health–Europe. 2025 Jun 27.
World Health Organization (WHO). World Report on Ageing and Health. Geneva: WHO; 2024.
Mehta JM, Manson JE. The menopausal transition period and cardiovascular risk. Nature reviews cardiology. 2024 Mar;21(3):203-11.
Anagnostis P, Stevenson JC. Cardiovascular health and the menopause, metabolic health. Best Practice & Research Clinical Endocrinology & Metabolism. 2024 Jan 1;38(1):101781.
World Health Organization. Assessing national capacity for the prevention and control of noncommunicable diseases: report of the 2021 global survey. World Health Organization; 2023 Jul 5.
Diabetes Research and Clinical Practice. Sex differences in metabolic syndrome prevalence during menopause.2022;188:109934. doi:10.1016/j.diabres.2022.109934.
World Health Organization. STEPS Georgia Report. Ministry of Internally Displaced Persons from the Occupied Territories, Labour, Health and Social Affairs of Georgia; 2016.
World Health Organization. STEPS Georgia Follow-up Survey. Ministry of Internally Displaced Persons from the Occupied Territories, Labour, Health and Social Affairs of Georgia; 2021.
Gumpeny N, Gumpeny L, Gumpeny SR. Metabolic syndrome in menopause. Exploration of Endocrine and Metabolic Diseases. 2025 Sep 24;2:101440.
De Paoli M, Zakharia A, Werstuck GH. The role of estrogen in insulin resistance: a review of clinical and preclinical data. The American journal of pathology. 2021 Sep 1;191(9):1490-8.
Sinatora RV, Chagas EF, Mattera FO, Mellem LJ, Santos AR, Pereira LP, Aranao AL, Guiguer EL, Araújo AC, Haber JF, Guissoni LC. Relationship of inflammatory markers and metabolic syndrome in postmenopausal women. Metabolites. 2022 Jan 13;12(1):73.
Zhu D, Chung HF, Dobson AJ, Pandeya N, Giles GG, Bruinsma F, Brunner EJ, Kuh D, Hardy R, Avis NE, Gold EB. Age at natural menopause and risk of incident cardiovascular disease: a pooled analysis of individual patient data. The Lancet Public Health. 2019 Nov 1;4(11):e553-64.
World Health Organization & International Diabetes Federation (WHO & IDF). Global Framework for NCD Prevention in Women 45+. Geneva: WHO; 2025.
İlhan GA, Yıldızhan B. Visceral adiposity indicators as predictors of metabolic syndrome in postmenopausal women. Turkish Journal of Obstetrics and Gynecology. 2019 Oct 10;16(3):164.
Kapoor E, Faubion SS, Kuhle CL, Kling JM, Miller VM, Fokken S, Mara KC, Moyer AM. The effect of genetic variation in estrogen transportation and metabolism on the severity of menopause symptoms: A study from the RIGHT 10K cohort. Maturitas. 2023 Oct 1;176:107797.
World Health Organization (WHO). Global Status Report on Physical Activity 2024. Geneva: WHO; 2024.
Minkin MJ. Menopause: hormones, lifestyle, and optimizing aging. Obstetrics and Gynecology Clinics. 2019 Sep 1;46(3):501-14.
Kapoor E. Menopause symptoms and the cortisol response. Menopause. 2022 Jan 1;29(1):6-7.
Darvish S, Murray KO, Ludwig KR, Avalani KH, Craighead DH, Freeberg KA, Bevers S, Reisz JA, D’Alessandro A, Moreau KL, Seals DR. Preservation of vascular endothelial function in late-onset postmenopausal women. Circulation research. 2025 Feb 28;136(5):455-69.
Vallée A. Menopause and risk of atherosclerotic cardiovascular disease: insights from a women's UK Biobank cohort. Maturitas. 2025 Oct;201:108693
Genazzani AD, Petrillo T, Semprini E, Aio C, Foschi M, Ambrosetti F, Sponzilli A, Ricciardiello F, Battipaglia C. Metabolic syndrome, insulin resistance and menopause: the changes in body structure and the therapeutic approach. Gynecol Reprod Endocrinol Metab. 2024;4:086-91.
Ciarambino T, Crispino P, Leto G, Mastrolorenzo E, Para O, Giordano M. Influence of gender in diabetes mellitus and its complication. International journal of molecular sciences. 2022 Aug 9;23(16):8850.
Kim JE, Kim JS, Jo MJ, Cho E, Ahn SY, Kwon YJ, Ko GJ. The Roles and Associated Mechanisms of Adipokines in Development of Metabolic Syndrome. Molecules. 2022 Jan 6;27(2):334.
World Health Organization (WHO). STEPS Georgia Follow-up Survey 2021: Noncommunicable Disease Risk Factor Survey. Ministry of Internally Displaced Persons from the Occupied Territories, Labour, Health and Social Affairs of Georgia; 2021.
Anekwe CV, Cano A, Mulligan J, Ang SB, Johnson CN, Panay N, Schaedel Z, Akam EY, Porterfield F, Wang E, Nappi RE. The role of lifestyle medicine in menopausal health: a review of non-pharmacologic interventions. Climacteric. 2025 Sep 3;28(5):478-96..
World Health Organization (WHO) & International Diabetes Federation (IDF). Global Framework for NCD Prevention in Women Aged 45+. Geneva; 2025.
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