Cardiovascular disease is the leading cause of death in women, yet the risk is often missed in midlife. This Clinical Expert Series argues that the menopause transition is not merely a symptom phase but a window of adverse cardiometabolic change beyond chronological ageing, and that ob-gyns are well placed to catch it.
The review draws together longitudinal changes in lipids, blood pressure, glucose metabolism, body composition and vascular function across the transition, and the risk carried by early or surgical menopause and by symptoms such as vasomotor complaints, poor sleep and low mood. The argument is to fold these menopause-specific factors into routine cardiovascular risk assessment.
In practice this means using the menopause consultation to measure blood pressure, lipids, glucose and weight trend, to treat early or surgical menopause as a risk marker, and to co-manage with primary care or cardiology when risks cluster. For many Indian women the gynaecologist is the main point of midlife contact, which makes this the realistic place to start prevention.
- Use the menopause visit to measure blood pressure, fasting lipids and glucose, and to note body-composition change.
- Treat early or surgical menopause as a marker of higher cardiovascular risk warranting closer follow-up.
- Ask about vasomotor symptoms, sleep and mood, each of which tracks with cardiometabolic risk, not only quality of life.
- Co-manage with primary care or cardiology when risk factors cluster.
- Frame midlife as the point to begin prevention rather than defer it.
Why it matters
The ob-gyn is often the only doctor a midlife woman sees, so her cardiovascular risk goes unrecorded unless this visit captures it.
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