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Benjamin Franklin once remarked that the only things certain in this world are death and taxes, but as any woman can attest to, there is another certainty in life—menopause. Defined as the final menstrual period and usually confirmed when a woman has missed her periods for 12 consecutive months, menopause marks the permanent end of fertility. This “change of life” usually occurs around age 51 and affects every woman differently. While the only symptom for some women will be the end of menstruation, others will experience more profound physical and emotional challenges, including hot flashes, night sweats, mood swings, aching joints, thinning hair, and memory lapses. Several chronic medical conditions can also develop after menopause. When estrogen levels decline the risk of cardiovascular disease increases, as does the risk of osteoporosis. But at this time of life, it isn’t always possible to tell if symptoms are related to menopause, aging, or both. So to better understand the “changes women experience during life,” researchers at the University of Pittsburgh embarked on a ten-year study, and this is what they discovered.

Each year the researchers tested 1,054 study participants for heart disease risk factors including cholesterol, blood pressure, blood glucose, and insulin. In nearly all of the women, cholesterol levels rose sharply around the time of menopause. In the two-year time period surrounding their final menstrual period, the women’s average LDL, or the “bad” cholesterol that blocks arteries, rose by about 10.5 points, or around 9 percent and average total cholesterol level increased by 6.5 percent. “As they approach menopause, many, many women show a very striking increase in cholesterol levels, which in turn increases risk for later heart disease,” said Dr. Karen A. Matthews, lead author of the study and professor of psychiatry and epidemiology at the University of Pittsburgh.

During the study, other risk factors such as insulin and systolic blood pressure also increased, but at a steady rate, which suggests the changes were related to aging and not menopause. “Other risk factors we measured didn’t show a dramatic change,” Matthews said. “I expected to see some change in inflammatory factors because some data suggest that hormone users have higher cholesterol levels, but it did not occur.”