Menopause (Climacteric): Effects and Consequences

Postmenopausal – that is, after the period has ended in women – the risk of diseases such as osteoporosis, cardiovascular disease, adult-onset diabetes or breast cancer increases. In the following, we present the correlations in more detail.

Osteoporosis after menopause

There are clear gender differences in the incidence of osteoporosis-type fractures: Women have a two- to threefold higher fracture risk than men. Fracture rates increase exponentially at older ages.

Estrogens promote the build-up of bone substance by stimulating bone metabolism. If fewer estrogens are present after menopause, the overall effect is reduced by the corresponding factor.

Cardiovascular disease after menopause.

The risk of cardiovascular disease also increases with age when there are fewer natural estrogens circulating in the blood. Estrogens protect blood vessels because they increase the amount of “good” high-density lipoprotein (HDL) cholesterol, which prevents atherosclerosis and heart attacks.

In Germany, 186,000 women and 153,000 men die each year from diseases of the cardiovascular system. In women, they are numerically the leading cause of serious illness and every second cause of death. Postmenopausal women are more frequently affected than pre-menopausal women.

The vasoprotective effect can only be demonstrated with endogenous estrogens. Taking synthetic estrogens does not prevent cardiovascular disease. On the other hand, even the WHI study (Women’s Health Initiative), a broad-based study on hormone therapy, which was actually conducted to provide positive evidence for this form of therapy, was discontinued. Estrogen therapy increased the risk of heart attack and stroke.

Body weight and adult-onset diabetes

Altered fat metabolism also affects body weight because caloric requirements decrease during menopause. If those affected do not change their eating habits or increase energy consumption by exercising more, they gain weight.

For example, while 22.8 percent of women aged 40 to 49 in North Rhine-Westphalia are overweight (body mass index, BMI > 29), this is the case for 31.1 percent of those aged 50 to 59 and 38.0 percent of those aged 60 to 69. The risk of developing adult-onset diabetes increases.

Breast cancer risk increases with age

Breast cancer is the most common cancer among women in Germany and the leading cause of cancer death. Statistically, every eighth to tenth woman is affected during her lifetime, and the average age at first diagnosis is 63. Every year, about 70,000 women in Germany develop breast cancer, almost a third of them under the age of 55. Errors in cell division become more likely with increasing age.

Relevant factors that increase the risk of disease include:

  • Familial predisposition
  • Smoking
  • Alcohol consumption
  • Obesity

Similarly, hormone therapy leads to an increased risk of breast cancer. The Million Women Study, which surveyed one million British women between the ages of 50 and 64 about their use of sex hormones, clearly demonstrated that hormone therapy increases the risk of breast cancer in proportion to the duration of use.