Navigating Metabolic Shifts: Why Postmenopausal Women Need Proactive Health Management
The period following menopause marks a meaningful shift in a woman’s health landscape, notably increasing the risk of developing conditions like diabetes and related metabolic issues. This is largely due to the decline in protective hormones, particularly estrogen, which impacts fat distribution and increases susceptibility to fatty liver disease.Despite this heightened risk, data from Germany indicates postmenopausal women are frequently enough undertreated according to established guidelines for managing cholesterol and blood pressure – key factors in preventing heart attack and stroke.
As estrogen levels fall, the body’s fat distribution changes, contributing to a noticeable rise in metabolic dysfunction-associated steatotic liver disease (MASLD), previously known as non-alcoholic fatty liver disease. Before menopause, women experience MASLD at roughly half the rate of men, but this disparity diminishes significantly after menopause. Progressive liver fibrosis is increasingly observed, especially in women also experiencing insulin resistance or diabetes, according to experts like Professor Dr. med. Johannes szendrödi, President of the German Diabetes Society (DDG).
Recognizing this interconnectedness, specialist societies recommend regular health screenings for postmenopausal women. These should begin with blood tests and simple scoring systems, progressing to ultrasound or elastography if abnormalities are detected. “The heart and liver age together with the metabolism. The menopause is the moment when prevention has to start again,” emphasizes Professor Szendrödi.
While hormone replacement therapy can offer metabolic benefits, it isn’t a global solution. It’s most appropriate for women experiencing severe menopausal symptoms and with a low risk of vascular issues, requiring a thorough individual risk assessment. However, Professor Szendrödi stresses that “exercise is more important than hormone replacement preparations.” Muscle training, performed 2-3 times weekly alongside endurance activities, demonstrably increases insulin sensitivity, lowers blood sugar, and provides lasting protection for the heart and blood vessels – all without the potential side effects of medication.
Here are key steps women can take to proactively manage their health after menopause:
* Regular Health Checks: Monitor blood sugar, blood lipids, blood pressure, and liver values.
* Prioritize Exercise: incorporate targeted muscle training 2-3 times a week, complemented by endurance activities.
* Nutritious Diet: Focus on a diet rich in vegetables, fiber, and healthy vegetable fats, while limiting sugar and processed foods.
* Restful Sleep & Stress Management: Prioritize adequate sleep and effective stress reduction techniques to support metabolic health.
* Individualized Medical Consultation: Discuss the potential benefits and risks of hormone therapy with a healthcare professional.
“Knowledge is the first step towards prevention,” concludes Professor Szendrödi. “If you understand how the body changes, you can take targeted countermeasures and use the menopause as an possibility. It is a turning point - and the beginning of a new phase of strength.”
The DDG recently presented current scientific findings on menopause and diabetes, alongside other aspects of women’s health and their connection to diabetes, at a press conference. the 2025 Diabetes Autumn Conference, led by Professor Dr.med. Karsten Müssig,conference president and chief physician at the Clinic for Internal Medicine,Gastroenterology and Diabetology at the Franziskus Hospital Harderberg of the Niels Stensen Clinics,specifically focused on critical life phases – including puberty,pregnancy,and menopause – and the interplay between hormones and diabetes.
(Source: diabetes risk image provided by Monika Gause for www.diabsite.de)
(Last edited: 12.11.2025)
