Climacteric status at the age of 46: impact on metabolic outcomes in population-based study.

Context: Menopausal transition is associated with increased cardiovascular risks. Available data on the effect of earlier climacterium on these risks is limited.

Objective: To compare cardiovascular risk-associated parameters at the ages of 14, 31 and 46 in relation to climacteric status at the age of 46.

Design, Setting and Participants: A prospective cohort study including 2685 women from the Northern Finland Birth Cohort 1966.

Main Outcome Measures: Follicle-stimulating hormone (FSH), body mass index (BMI), waist circumference, waist-to-hip ratio (WHR), blood pressure (BP), body composition, cholesterol levels, testosterone levels, free androgen index (FAI), high-sensitivity C-reactive protein (hs-CRP) and liver enzymes.

Results: Women who were climacteric at the age of 46 had lower BMIs (P = 0.029), testosterone levels (P = 0.018) and FAIs (P = 0.009) at the age of 31. At the age of 46, they had less skeletal muscle (P < 0.001), a higher fat percentage (P = 0.016), higher cholesterol levels (total cholesterol [P < 0.001], low-density lipoprotein [LDL-C] [P < 0.001], high-density lipoprotein [HDL-C] [P = 0.022], and triglycerides [P = 0.008]) and higher alanine aminotransferase (ALT) (P=0.023) and gamma-glutamyltransferase (GGT) (P < 0.001) levels compared to preclimacteric women. Waist circumference, WHR, BP and hs-CRP levels did not differ between the groups. 111/381 of the climacteric women were using hormone replacement therapy (HRT). In sub-analysis that excluded the HRT-users, triglycerides, HDL-C and body fat percentage did not differ between the groups.

Conclusions: Earlier climacterium is associated with mainly unfavourable metabolic changes.