Metabolic Syndrome and Excessive Body Weight in Peri-and Postmenopausal Women

Metabolic syndrome (MetS) has been associated with the endocrine, metabolic, and immunological functions of the adipose tissue. In parallel, obesity is strongly associated with disorder of glucose, lipid metabolism, and insulin resistance, and it is considered a common predisposing factor for elevated risk of several serious health conditions including insulin resistance, type 2 diabetes mellitus, hypertension and other cardiovascular disease (CVD), fatty liver disease, and some types of cancer. The incidence of CVD in women increases substantially with aging, probably because the menopause diminishes the gender estrogenic protection, thus contributing to an adverse impact on cardiovascular risk variables. CVD has become the leading cause of death for women. In this setting, the perimenopause must be considered a critical period in women’s life because it leads to several adverse changes especially in the lipid profile and modifies cardiovascular risk factors. Therefore, it could be necessary to encourage lifestyle measures and therapeutic interventions such as personalized hormone replacement therapy (HRT) throughout the perimenopause in order to counteract or prevent these events. HRT for postmenopausal women has been available for more than 60 years. Ever since, HRT has been a subject of discussion and debate regarding its safety and efficacy; nowadays it is well established that timing in the initiation and the type, dose, and route of HRT are crucial for the success of therapy, as well as for the control of possible adverse effects.