Editing Menopause (section)

=== Long-term effects ===
==== Cardiovascular health ====
Exposure to endogenous [[estrogen]] during reproductive years provides women with protection against [[cardiovascular disease]], which is lost around 10 years after the onset of menopause. The menopausal transition is associated with an increase in [[fat mass]] (predominantly in [[visceral fat]]), an increase in [[insulin resistance]], [[Dyslipidemia|dyslipidaemia]], and [[endothelial dysfunction]].<ref>{{cite journal |vauthors=Nappi RE, Chedraui P, Lambrinoudaki I, Simoncini T |date=June 2022 |title=Menopause: a cardiometabolic transition |journal=The Lancet. Diabetes & Endocrinology |language=English |volume=10 |issue=6 |pages=442–456 |doi=10.1016/S2213-8587(22)00076-6 |pmid=35525259 |s2cid=248561432}}</ref>  Women with [[vasomotor symptoms]] during menopause seem to have an especially unfavorable cardiometabolic profile,<ref>{{cite journal |vauthors=Thurston RC |date=April 2018 |title=Vasomotor symptoms: natural history, physiology, and links with cardiovascular health |journal=Climacteric |volume=21 |issue=2 |pages=96–100 |doi=10.1080/13697137.2018.1430131 |pmc=5902802 |pmid=29390899}}</ref> as well as women with premature onset of menopause (before 45 years of age).<ref>{{cite journal |vauthors=Stevenson JC, Collins P, Hamoda H, Lambrinoudaki I, Maas AH, Maclaran K, Panay N |date=October 2021 |title=Cardiometabolic health in premature ovarian insufficiency |journal=Climacteric |volume=24 |issue=5 |pages=474–480 |doi=10.1080/13697137.2021.1910232 |pmid=34169795 |s2cid=235634591 |doi-access=free|hdl=2066/238753 |hdl-access=free }}</ref> These risks can be reduced by managing risk factors, such as tobacco smoking, [[hypertension]], increased [[blood lipid]]s and body weight.<ref name="Souza20132">{{cite journal |vauthors=Souza HC, Tezini GC |date=September 2013 |title=Autonomic Cardiovascular Damage during Post-menopause: the Role of Physical Training |journal=Aging and Disease |volume=4 |issue=6 |pages=320–328 |doi=10.14336/AD.2013.0400320 |pmc=3843649 |pmid=24307965}}</ref><ref name="ESHRE20112">{{cite journal |author1=ESHRE Capri Workshop Group |year=2011 |title=Perimenopausal risk factors and future health |journal=Human Reproduction Update |volume=17 |issue=5 |pages=706–717 |doi=10.1093/humupd/dmr020 |pmid=21565809}}</ref>

==== Bone health ====
The annual rates of [[Bone density|bone mineral density]] loss are highest starting one year before the final menstrual period and continuing through the two years after it.<ref>{{cite journal |vauthors=Warming L, Hassager C, Christiansen C |date=2002-02-01 |title=Changes in bone mineral density with age in men and women: a longitudinal study |journal=Osteoporosis International |volume=13 |issue=2 |pages=105–112 |doi=10.1007/s001980200001 |pmid=11905520 |s2cid=618576}}</ref> Thus, post menopausal women are at increased risk of [[osteopenia]], [[osteoporosis]] and [[fracture]]s.