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Menopausal Hormone Therapy for Preventing Weight Gain and Cardiovascular Disease

Archives of Obesity and Metabolism / Archives of Obesity and Metabolism, (P)2951-0333; (E)2951-0597
2023, v.2 no.2, pp.54-63
https://doi.org/10.23137/AOM23.02.RA0007
Yeong Sook Yoon (Department of Family Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea)
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Abstract

Estrogen is crucial in regulating food intake, energy expenditure, glucose metabolism, and lipid metabolism. During menopause, the decline in estrogen levels predisposes women to weight gain, abdominal obesity, insulin resistance, type 2 diabetes, hypertension, and cardiovascular disease (CVD). Menopausal hormone therapy (MHT) prevents weight gain, improves lipid metabolism by lowering low-density lipoprotein cholesterol while raising high-density lipoprotein cholesterol, and delays the onset of type 2 diabetes in menopausal women. The effect of MHT on CVD in menopausal women remains controversial. The Women's Health Initiative study was terminated prematurely after it revealed that hormone administration increased the risk of myocardial infarction, stroke, and thromboembolism. However, some studies have found that MHT had no effect or decreased the risk of CVD. The inconsistent results were likely due to multiple factors, including the timing of hormone therapy initiation, duration of therapy, type and dosage, and presence or absence of CVD risk factors at the start of treatment. Despite its benefits in terms of managing weight gain and reducing the risk of type 2 diabetes, dyslipidemia, and CVD associated with obesity, it is not recommended as the primary therapy for weight loss or diabetes prevention.MHT is primarily indicated for postmenopausal women, who are likely to benefit from its potential to prevent weight gain and improve lipid metabolism.

keywords
Estrogens, Menopausal hormone therapy, Body weight, Adiposity, Lipid metabolism, Cardiovascular disease

Archives of Obesity and Metabolism