Cardiometabolic health in premature ovarian insufficiency. (3rd September 2021)

• Record Type: Journal Article
• Authors: Stevenson, J. C.; Collins, P.; Hamoda, H.; Lambrinoudaki, I.; Maas, A. H. E. M.; Maclaran, K.; Panay, N.
• Is Part Of: Climacteric. Volume 24:Number 5(2021)
• Page Start: 474
• Page End: 480
• Publication Date: 2021-09-03
• Subjects: Premature ovarian insufficiency -- lipids -- glucose and insulin -- body composition -- hemostasis -- metabolic syndrome -- diabetes mellitus -- blood pressure -- endothelial function -- inflammation -- atherosclerosis -- hormone replacement therapy; Menopause -- Periodicals; Menopause -- Hormone therapy -- Periodicals; Menopause -- Periodicals; Estrogen Replacement Therapy -- Periodicals; Gynecology -- Periodicals; Societies, Medical -- Periodicals; 612.665
• DOI: 10.1080/13697137.2021.1910232
• Languages: English
• ISSNs: 1369-7137

Abstract

Abstract: Premature ovarian insufficiency (POI) is an increasing public health problem with a prevalence now approaching 4%. POI results in adverse effects on the skeleton and central nervous system as well as disturbances of metabolic and cardiological factors that predispose to a major increased risk of cardiovascular disease (CVD). This article reviews the effects of the premature loss of ovarian function on lipids and lipoproteins, glucose and insulin metabolism, body composition, hemostasis and blood pressure, together with effects on the development of metabolic syndrome and diabetes mellitus. The article examines the effects of POI on vascular endothelial function and inflammation that result in arterial disease, and reviews the effects of hormone replacement therapy (HRT) on these various metabolic processes and on cardiovascular outcomes. It is essential that women with POI receive hormonal treatment to help prevent the development of CVD, and that this treatment is continued at least until the normal age of menopause. It appears that HRT has a more favorable effect than the combined oral contraceptive, but larger clinical trials are needed to establish the optimal treatment. Other therapeutic measures may need to be added to correct existing metabolic abnormalities and, in particular, attention to lifestyle factors such as diet and exercise must be encouraged.