Perimenopausal increase in serum cholesterol: a 10-year longitudinal study.

The relative contribution of menopause to the age-related increase in serum total cholesterol concentration in women is not exactly known. Cross-sectional studies suggest a considerable contribution of menopause, whereas in short-term longitudinal studies, only a small increase was observed around menopause. In a 10-year follow-up study (1979-1989), serum total cholesterol concentration and dietary intake were measured annually in 167 healthy perimenopausal women (initially aged 49-56 years) who lived in the mixed rural/industrial community of Ede, the Netherlands. The longitudinal design enabled us to study the "natural course" of serum total cholesterol concentration and the influence of dietary fat intake during and after cessation of ovulation. For data analysis, three menopausal cohorts were created based on years relative to menopause: 2 years before ("perimenopausal"), 2 years after ("early postmenopausal"), and 6 years after ("late postmenopausal"). In each cohort, the analysis was conducted on data from 4 years of follow-up. The results show that from 2 years before to 6 years after menopause, serum total cholesterol concentration increased on average by at least 1.1 mmol/liter (19%). Thereafter, only a minor increase was observed. The rise was significantly lower in women who increased their intake of polyunsaturated fatty acids as compared with women who reduced their intake during that period. It is concluded that cessation of ovulation appears to be associated with a major increase of 19% in serum total cholesterol concentration during an 8-year period around menopause. This increase may be reduced by increasing the intake of polyunsaturated fatty acids.