Effects of the Transition from Premenopause to Postmenopause on Lipids and Lipoproteins: Quantification and Related Parameters

Background/Aims: The aim of this study was to quantitatively measure changes in lipids and lipoproteins during perimenopause and to identify variables related to these changes. Methods: Among women who had three regular health evaluations over a span of 2-4 years, 34 women remained in the premenopausal state, 34 premenopausal women transitioned to the post-menopausal state, and 36 postmenopausal women were enrolled. The menopausal state was determined not only by a history of amenorrhea but also by levels of female sex hormones. Yearly changes in lipids were calculated using a linear regression of the three measurements. Results: The transition from premenopause to postmenopause was associated with increased total cholesterol and low-density lipoprotein (LDL) cholesterol levels by 7.4 ${\pm}$ 8.0 mg/dL (4.2 ${\pm}$ 4.9%) and 6.9 ${\pm}$ 6.5 mg/dL (6.8 ${\pm}$ 7.0%) over one year, resulting in an elevation of 19.6 ${\pm}$ 22.6 mg/dL (10.9 ${\pm}$ 13.0%) and 18.9 ${\pm}$ 19.5 mg/dL (18.6 ${\pm}$ 20.3%), respectively, during perimenopause. There were no changes observed in premenopausal and post-menopausal women. Body weight, blood pressure, high-density lipoprotein (HDL) cholesterol, and triglycerides did not change in any of the three groups. In all women, changes in both total cholesterol and LDL cholesterol were associated with changes in follicle stimulating hormone (r = 0.40, p < 0.001 and r = 0.38, p < 0.001, respectively). Changes in triglycerides were associated with changes in body weight (r = 0.28, p = 0.005). Conclusions: During perimenopause, total and LDL cholesterol levels increase and these changes in cholesterol are mainly dependent on changes in female sex hormones.