Metabolic Disorders in Menopause and their Correction

Menopause represents a complex period in the women’s life. Several disorders of nutrition and metabolism are accompanying it. The information on this topic is increasing. The carbohydrate disturbances include impaired glucose tolerance (IGT) and type 2 diabetes mellitus (T2DM), but not only. The estrogen deficiency could be an essential contributor to the process of diabetogenesis. Other significant factors for the risk of T2DM are: ageing, obesity (with increasing incidence after menopause), lowering of physical activity, smoking, drinking, some drugs a.s.o. Unfortunately, there are in the scientific literature a number of controversies regarding the relation menopause – diabetes. For instance, an important American study (Diabetes Prevention Program) pointed out that natural menopause did not associate with an increased risk of diabetes and did not influence the answer to the preventive strategy. On the other hand, a large European trial (EPIC – InterAct Study) concluded that early menopause has produced a higher risk for T2DM. Referring to the control of diabetes in the menopause period, many studies emphasize on diet and improving lifestyle, with a major role of physical activity. It is interesting that metformin use in postmenopausal women with diabetes was associated with a lower incidence of invasive breast cancer. Hormone Replacement Therapy (HRT), proposed for the correction of menopause, seems not to be adequate for the women with T2DM. The increase in abdominal and, more particularly, visceral fat accumulation, is associated in menopause with a higher risk of developing an atherogenic lipid profile and an insulin-resistant state. Elevation of total cholesterol, LDL-cholesterol, triglycerides and lipoprotein (a) levels and lowering of HDL-cholesterol levels are observed in the menopause. There is an association between postmenopausal status and a substantial risk of the metabolic syndrome. The cardiovascular risk is also significantly modified. These disorders have a major impact on the quality and duration of life. Their control is in increasing attention of the medical staff