Research Article| Volume 17, ISSUE 3, P181-190, November 1993

Download started.


Influence of spontaneous and surgical menopause on atherogenic metabolic risk

      This paper is only available as a PDF. To read, Please Download here.


      We evaluated serum total-, LDL-, HDL-, cholesterol and triglycerides in 858 women. Sixty-seven were in premenopause, 307 in perimenopause, 326 in spontaneous menopause, and 158 women underwent hysterectomy. Of these, 101 had bilateral ovariectomy, 24 with unilateral ovariectomy and 33 with retention of both ovaries. After correcting for chronological age and body mass index by variance analysis, it was found that total-, LDL- and HDL-cholesterol significantly increased during menopause without changes in the total cholesterol/HDL-cholesterol, LDL-cholesterol/HDL-cholesterol and triglycerides/HDL-cholesterol ratio. The changes gradually occurred during the months preceding spontaneous cessation of menses. Atherogenic metabolic risk (as relative risk of high total and LDL-cholesterol, estimated by logistic regression analysis) significantly increased in all groups of women in reference to premenopause. The risk observed in surgical menopause with bilateral ovariectomy was higher than in spontaneous menopause, and conservation of ovaries in hysterectomized women seems to protect only partially against such an increase.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Maturitas
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Gordon T
        • Kannel WB
        • Hjortland MC
        • McNamara PM
        Menopause and coronary heart disease.
        Ann Intern Med. 1978; 89: 157-161
        • Bengtsson C
        • Lindquist O
        Coronary heart disease during the menopause.
        in: Oliver MF Coronary heart disease in young women. Churchill Livingstone, New York1978: 234-239
        • Rosenberg L
        • Hennekens CH
        • Rosner B
        • Bellanger C
        • Rothman KJ
        • Speizer FE
        Early menopause and the risk of myocardial infarction.
        Am J Obstet Gynecol. 1981; 139: 47-51
        • Colditz GA
        • Willet WC
        • Stampfer MJ
        • Rosner B
        • Speizer FE
        • Hennekens CH
        Menopause and the risk of coronary heart disease in women.
        N Engl J Med. 1987; 316: 1105-1110
        • Witteman JCM
        • Grobbee DE
        • Kok FJ
        • Hofman A
        • Valkenburg HA
        Increased risk of atherosclerosis in women after the menopause.
        Br Med J. 1989; 298: 642-644
        • Sitruk-Ware R
        • Ibarra de Palacios P
        Oestrogen replacement therapy and cardiovascular disease in postmenopausal women.
        in: A review. Maturitas. 11. 1989: 259-274
        • Bonithon-Kopp C
        • Scarabin P-Y
        • Darne B
        • Malmejac A
        • Guize L
        Menopause-related changes in lipoproteins and some other cardiovascular risk factors.
        Int J Epidemiol. 1990; 19: 42-48
        • Sarrel PM
        Ovarian hormones and the circulation.
        Maturitas. 1990; 12: 287-298
        • Heiss G
        • Tannis I
        • Davies CE
        • Tyroler HA
        • Rifkind BM
        • Schonfeld G
        • Jacobs D
        • Frantz ID
        Lipoprotein cholesterol distibutions in selected North American populations: The Lipid Research Clinics Program Prevalence Study.
        Circulation. 1980; 61: 302-315
        • Notelovitz M
        • Gudat JC
        • Ware MD
        • Dougherty MC
        Lipids and lipoproteins in women after oophorectomy and the response to estrogen therapy.
        Br J Obstet Gynaecol. 1983; 90: 171-177
        • Pansini F
        • Bergamini C
        • Bettocchi S
        • Bassi P
        • Malfaccini M
        • Bagni B
        • Mollica G
        Short-term effect of oophorectomy on lipoprotein metabolism.
        Gynecol Obstet Invest. 1984; 18: 134-139
        • Campos H
        • McNamara JR
        • Wilson PWF
        Differences in low density lipoprotein subfractions and apolipoproteins in premenopausal and postmenopausal women.
        J Clin Endocrinol Metab. 1988; 67: 30-35
        • Matthews KA
        • Meilahn E
        • Kuller LH
        • Kelsey SF
        • Gaggiula AW
        • Wing RR
        Menopause and risk factors for coronary heart disease.
        N Engl J Med. 1989; 321: 641-646
        • Farish E
        • Fletcher CD
        • Hart DM
        • Smith ML
        Effects of bilateral oophorectomy on lipoprotein metabolism.
        Br J Obstet Gynaecol. 1990; 97: 78-82
        • Jensen J
        • Nilas L
        • Christiansen C
        Influence of menopause on serum lipids and lipoproteins.
        Maturitas. 1990; 12: 321-331
        • Friedwald WT
        • Levy RI
        • Fredrickson DS
        Estimation of the concentration of low-density lipoprotein cholesterol in plasma without use of the preparative centrifuge.
        Clin Chem. 1972; 18: 499-502
        • Castelli WP
        • Garrison RJ
        • Wilson PWF
        • Abbot RD
        • Kalousdian S
        • Kannel WB
        Incidence of coronary heart disease and lipoprotein cholesterol levels: The Framingham Study.
        J Am Med Assoc. 1986; 256: 2835-2838
        • Castelli WP
        The triglyceride issue: a view from Framingham.
        Am Heart J. 1986; 112: 432-437
      1. Arch Intern Med. 1988; 148: 36-69
        • Schlesselman JJ
        Case-control studies. Design, conduct, analysis.
        Oxford University Press, Oxford1982
        • Barret-Connor E
        Postmenopausal estrogen cancer and other considerations.
        Women Health. 1986; 11: 179-195
        • Moore FE
        • Gordon T
        Serum cholesterol levels in adults: United States, 1960–1962.
        in: Vital Health Stat, no 22. US Govt Printing Office, Washington DC1967
        • Tall AR
        • Small DM
        Body cholesterol removal: role of plasma high density lipoproteins.
        Adv Lipid Res. 1980; 17: 1-51
        • Aravantinos DJ
        Keeping or removing the ovaries at the time of hysterectomy.
        Eur J Obstet Gynecol Reproduct Biol. 1988; 28: 140-146
        • Siddle N
        • Sarrel P
        • Whitehead M
        The effect of hysterectomy on the age at ovarian failure: identification of a subgroup of women with a premature loss of ovarian function and literature review.
        Fertil Steril. 1987; 47: 94-100
        • Colvin Jr, PL
        • Auerbach BJ
        • Koritnik DR
        • Hazzard WR
        • Applebaum-Bowden D
        Differential effects of oral estrone versus 17-β estradiol on lipoproteins in postmenopausal women.
        J Clin Endocrinol Metab. 1990; 70: 1568-1573