Postmenopausal Changes In Women

Women have proven to have a higher risk of type 2 diabetes mellitus (DM), cardiovascular disease (CVD), and other chronic diseases in the postmenopausal stage of their lives than those who are in the premenopausal stage, regardless of ethnicity. Many of these CVDs continue to emerge as the leading causes of death in the Western world (Gaillard). Menopause tends to have drastic effects on metabolism and often makes women who are in the menopausal stage much more susceptible to metabolic syndrome. In comparison to men who are in the same age group, the risks for many types of disease are drastically increased for women (Wenger). Many researchers have attributed these risk increases to the various hormonal changes that have the ability to change
the susceptibility of insulin resistance and the redistribution of fat in the abdominal area (Lejsková).
The average age for a woman to go through menopause naturally is 51, this number can be later or earlier depending on the menopause is induced through some type of medical procedures (i.e.
hysterectomy, chemotherapy, or pelvic radiation therapy). In the U.S., there are roughly 46 million adult postmenopausal women (PMPW) and over 500 billion women worldwide (http://www.menopause.org/publications/other-resources/terms-statistics). PMPW tend to show significant differences in metabolism and overall body composition in comparison to those who are in the premenopausal stage. One has to take into account of what those significant changes are in postmenopausal women in order to make substantial conclusions. For example, the physical changes that PMPW undergo include the redistribution of fat in the abdominal area and the metabolic changes include, drastic decreases of the estrogen hormone, the culmination of these changes in women during the menopausal phase of life may result in the development of T2D in women across all racial and ethnic boundaries with different variations of reactivity across these boundaries
(Lynch). Studies have shown that older overweight women of various ethnic and racial backgrounds have a higher percentage of physical health problems (i.e.
functional disability, hypertension, osteoarthritis, and heart disease) as well as psychological/ emotional problems (i.e. depression, low self- esteem, suicidal thoughts) (Lynch). But interestingly, there have also been studies regarding how nonobese women, who are characterized as ‘metabolically obese, normal-weight (MONW)’ share some of the same characteristics as obese women would. In a recent Korean study, researchers have found that MONW postmenopausal women are susceptible to the same diseases as their obese counterparts because there is a lack of physical activity, low expenditure of energy, and poor cardiopulmonary fitness (Choi). Also, these MONW individuals are like obese individuals in many ways because there is a high level of visceral fat, high plasma triglycerides (TG) levels, and a high level of insulin resistance (IR). The MONW group in most ways is very similar to those who are obese except the physical appearance as it relates to the normal body mass index (BMI). It is imperative to note that though the risk for T2D is increased in post-menopausal women despite weight and BMI, the severity of the risk is influenced by weight and BMI
(Lynch).
Overall, obesity does begin to play a bigger role in insulin sensitivity in PMPW as time goes on. Across several racial groups the Gaillard group finds that the higher the obesity the more likely the there is a higher risk for T2D and other CVDs. It is important to note that even though amongst all groups there is a higher risk for IR, T2D, and CVD if a postmenopausal woman is overweight or obese; there is one racial group, African American (AA), that essentially exponentially increases the risk for all these diseases, especially T2D (Gaillard). The AA group by far has the highest risk for many CVDs that are proving to be lethal for many AAs, especially African- American women (AAW).