Menopause signals the end of women’s reproductive
life . It has an important role in future disease risk. For example, an
early age at menopause is associated with an increased risk of
cardiovascular disease (CVD) and bone fractures. Conversely, an
early menopause protects against breast, endometrial and ovarian
cancer. loss of ovarian function and subsequent decline in endogenous
estrogens play as mediators of these differences in risk. While the
relationship between menopausal age and CVD risk is well
established, its association with type 2 diabetes, remains unclear. As
the few epidemiological studies that have investigated this association
yielded conflicting results. However, this association can be
explained by several evidences. First, menopause is associated with
cessation of ovarian production of estrogen. This decline can be
considered as one of the factors that play a pivotal role in
development and progression of the metabolic syndrome. This can be
observed in postmenopausal women who received estrogen therapy
and had a reduction in their fasting plasma glucose (FPG) levels.
Second, menopausal transition characterized by changes in the
distribution of body fat with increasing in abdominal fat deposition
under the effect of low estrogen and high androgen. This is associated
with a disturbance in the production of a several hormones as
adiponectin , leptin , gherlin that are associated with insulin
resistance and the metabolic syndrome. Third, menopause is
associated with continuation of androgen & testosterone production,
that are associated with glucose intolerance in both premenopausal
and postmenopausal women. AS in polycystic ovary syndrome
(PCOS) which characterized by higher androgen levels, and greater
risk of diabetes. |
