Mid- to Long-Term Women's Health Management: Too Late After Menopause; Blood Sugar Already Worsens During Transition

For nearly half of South Korean women over 50, managing health during and after menopause is a critical national health priority. The average age of menopause in Korea is 49.9, meaning women spend over a third of their lives post-menopause. However, menopause is often perceived merely as a phase of discomfort like hot flashes or insomnia, rather than a significant health juncture.

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The changes in health indicators appeared not after menopause ended, but from the transition period when menstrual cycles began to become irregular.

In reality, metabolic changes begin during the menopausal transition, characterized by irregular periods. A prospective study tracking over 5,000 women aged 42-52 from 2014 to 2017 confirmed these shifts. The research found that increases in abdominal obesity and high cholesterol levels were already evident in the early stages of the menopausal transition, even before menopause was complete. Waist-to-height ratio, an indicator of abdominal obesity, rose from 21.2% in pre-menopausal women to over 25% in the early transition phase, while high cholesterol increased from 8.3% to 11%.

Notably, these changes were not always apparent when looking solely at body weight or BMI. The distribution of body fat shifted, with visceral fat accumulating around the abdomen. This type of fat is a key factor in reduced insulin sensitivity and elevated blood lipids, significantly increasing the risk of type 2 diabetes and cardiovascular disease. As the menopausal transition progressed, participants showed increases in weight, waist circumference, body fat, fasting blood glucose, HbA1c (a measure of average blood sugar over 2-3 months), insulin resistance, and LDL cholesterol.

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The increase in insulin resistance was also observed as the menopausal transition phase progressed.

Insulin resistance, where the body's cells don't respond effectively to insulin, emerged as a key concern. As insulin resistance increases, the pancreas produces more insulin, raising the risk of type 2 diabetes. The study suggests that the menopausal transition itself, independent of general aging, contributes to increased insulin resistance and metabolic disease risk. This indicates that deteriorating blood sugar and cholesterol levels in women in their late 40s cannot be solely attributed to aging.

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It is important to regularly check blood sugar and cholesterol levels and manage lifestyle habits such as exercise and balanced meals starting from this period.

The decline in estrogen, a key female hormone, plays a significant role. Estrogen influences not only reproductive functions but also fat distribution, blood sugar and cholesterol regulation, and vascular and bone health. Reduced estrogen levels can lead to increased abdominal fat, metabolic changes, and decreased bone density, heightening osteoporosis risk. These physical changes impact quality of life, with women in the menopausal transition reporting more symptoms like hot flashes, night sweats, psychological distress, physical discomfort, and sexual difficulties compared to pre-menopausal women. The study also highlighted significant sleep problems affecting over a third of participants. Experts stress that managing health should begin during the transition phase, not after menopause, through regular monitoring of metabolic indicators and adopting healthy lifestyle habits.

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If symptoms are severe or prolonged, rather than enduring them as a natural part of aging, it is necessary to actively check your condition and receive appropriate management and treatment.