Menopause-driven metabolomic shifts: unraveling cardiovascular disease risk in women

Abstract Menopause marks the end of a woman's reproductive life, and the transition to this stage is accompanied by profound physiological and metabolic changes. These include alterations in lipoproteins and various metabolites, such as lipids, fatty acids, and amino acids, resulting in a more atherogenic profile and, in some cases, an increased risk in cardiovascular disease (CVD). CVD remains the leading cause of death among women, and lipid profiles change substantially in postmenopause, representing a key sex-specific risk factor. Thus, elucidating the metabolic pathways affected during menopause is crucial to reducing the burden of menopause-related conditions. However, the underlying molecular mechanisms of this increased metabolic burden remain incompletely understood. Recent advances in metabolomic technologies, including mass spectrometry (MS), nuclear magnetic resonance (NMR), and computational tools, have greatly improved our ability to characterize these metabolic shifts. This review summarizes current knowledge on the metabolic changes associated with menopause and their implications for CVD development.