The metabolic syndrome (MetS) comprises individual components including central obesity,
insulin resistance, dyslipidaemia and hypertension and it is associated with an increased risk of cardiovascular
disease (CVD) and type 2 diabetes mellitus (T2DM). The menopause per se increases the incidence
of MetS in aging women. The effect(s) of menopause on individual components of MetS include:
i) increasing central obesity with changes in the fat tissue distribution, ii) potential increase in insulin
resistance, iii) changes in serum lipid concentrations, which seem to be associated with increasing
weight rather than menopause itself, and, iv) an association between menopause and hypertension, although
available data are inconclusive. With regard to the consequences of MetS during menopause,
there is no consistent data supporting a causal relationship between menopause and CVD. However,
concomitant MetS during menopause appears to increase the risk of CVD. Furthermore, despite the data
supporting the association between early menopause and increased risk of T2DM, the association between
natural menopause itself and risk of T2DM is not evident. However, the presence and the severity
of MetS appears to be associated with an increased risk of T2DM. Although the mechanism is not clear,
surgical menopause is strongly linked with a higher incidence of MetS. Interestingly, women with polycystic
ovary syndrome (PCOS) have an increased risk of MetS during their reproductive years; however,
with menopausal transition, the risk of MetS becomes similar to that of non-PCOS women.
