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Amelia Carro Hevia Spotlights New Review: Lipid Metabolism in Women
Amelia Carro Hevia/LinkedIn
Nov 16, 2025, 05:20

Amelia Carro Hevia Spotlights New Review: Lipid Metabolism in Women

Amelia Carro Hevia, Consultant Cardiologist and Researcher at Corvilud Institut, posted on LinkedIn:

”LIPID METABOLISM IN WOMEN: A REVIEW

Cardiovascular disease remains the leading cause of mortality in women worldwide. This review highlights how menopause-related hormonal changes significantly alter lipid metabolism, increasing atherogenic risk and shaping preventive strategies in female patients.

The evidence provided comes mainly from cohort data (SWAN, ALSPAC, meta-analyses) and experimental findings. Most recommendations rely on observational rather than randomized controlled data; this translates to moderate-level supporting evidence (B) in guideline frameworks.​​

MAIN REMARKS
Menopausal Transition Alters Lipids
Menopause is associated with increased total cholesterol, LDL-cholesterol, triglycerides, and unfavorable HDL and lipoprotein(a) changes—contributing to higher atherosclerotic cardiovascular disease (ASCVD) risk in women.​

Distinct Lifelong Lipid Patterns: Lipid profiles differ by sex and life stage.
– Before menopause, women generally have higher HDL and lower LDL than men.
– After menopause, LDL ↑ steeply, and HDL function worsens despite stable concentrations.​

Body Weight and Hormones Influence Risk
– Lower body weight during menopause is linked to sharper LDL ↑, likely due to lower estrogen.
– Both estrogen and FSH modulate cardiovascular and lipid risk.​

Menopausal Hormone Therapy (MHT)
– Oral or transdermal MHT ↓ LDL by 3–22% and ↑ triglycerides and HDL mildly, but is not recommended for primary/secondary CVD prevention.
– Selective use soon after menopause may ↓ coronary risk, aligning with timing (“window of opportunity”) hypothesis.​​

Lipoprotein(a) Rises Post-Menopause
– Lower estrogen post-menopause leads to ↑ Lp(a), with added cardiovascular risk.
– MHT may ↓ Lp(a), but clinical decisions should consider overall ASCVD risk.

CONSIDERATIONS

Taking on mind authors statements within recent 2025 Focused Update on Dyslipidemia Guidelines, I would strongly insist on:
1. Rountine consideration of Lp(a) measurement in post-menopausal women.
2. Lipid Lowering therapy intensification (statin upgrade, combinations with bempedoic, PCSK9i, inclisiran) if LDL goals are unmet, especially in high-/extreme-risk women.
3. MHT prescription only for menopausal symptom relief within 10 years post-menopause/under 60, not for CVD prevention.​
4. Always applying SCORE2/OP risk algorithms for individualized assessment.
5. There’s an inflammatory pathway that acts through women’s lives. It might contribute to CVD risk after menopause. This is still a field of research that would probably improve our knowledge & management of this population.

There is no doubt on the role of menopause as a pivotal time for lipid risk escalation in women. Preventive interventions must leverage guideline-aligned LDL and Lp(a) targets, individualized risk estimation, and caution with MHT for CVD protection

SOURCE here.

Title: Lipid metabolism in women: A review

Authors: Julie A.E. van Oortmerssen, Janneke W.C.M. Mulder, Maryam Kavousi, Jeanine E. Roeters van Lennep”

Lipid Metabolism

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Amelia Carro Hevia Atherosclerosis Corvilud Institut Health Hematology Hemostasis Hemostasis Today Janneke W.C.M. Mulder Jeanine E Roeters van Lennep Julie A.E. van Oortmerssen Lipid Metabolism Maryam Kavousi Medicine thrombosis Women health
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