Menopausal Status and Sex Hormones in New Zealand Women With First-Time Acute Coronary Syndromes

2025

Authors

Earle, N., Poppe, K., Rolleston, A., Logue, G., Pilbrow, A., Devlin, G., Wihongi, H., Gladding, P., Troughton, R., Kerr, A., Porter, G., Henare, K., Lumley, T., Grey, C., Richards, M., Pera, V., Coffey, S., Williams, M., Pegg, T., Ternouth, I., Harrison, W., Cameron, V., Heather, A., Doughty, R.

Abstract

Aim

To examine the relationships between menopausal status, clinical factors and sex hormones in New Zealand women with acute coronary syndromes (ACS), addressing the lack of specific data within this group.

Method

A substudy of the Multi-Ethnic NZ Study of ACS enrolled women from 10 hospitals. Plasma estradiol, testosterone, sex-hormone binding globulin (SHBG) and follicle-stimulating hormone (FSH) were measured. Here, univariate associations between menopausal status, sex hormones, and clinical factors were assessed using independent samples t-tests and chi-squared tests.

Results

786 women were enrolled in the substudy. Self-reported menopausal status was collected in 355 women (mean age 67, SD10). 311 (88%) were post-menopausal (mean age at final menstrual cycle=46 years). Ethnicities were 250 European, 90 Māori, 13 Pacific Peoples, 7 Other. Post-menopausal status was associated with lower estradiol (p=0.007) and higher FSH (p<0.001). No association was found between menopausal status and lipid profiles, BMI, history of hypertension, diabetes, extent of coronary disease on angiogram or left ventricular ejection fraction (LVEF). SHBG levels decreased with higher triglycerides (p<0.001), and were lower in women with hypertension (p=0.019) or diabetes (p<0.001). Higher FSH was associated with lower triglycerides (p<0.001), BMI (p<0.001), eGFR (p=0.047), LVEF (p=0.007), and lower diabetes prevalence(p=0.018). Increased testosterone was associated with higher haemoglobin (p=0.038). Estradiol and testosterone:estradiol were not significantly associated with clinical factors.

Conclusion

Preliminary results indicate associations between sex hormones, menopausal status, and clinical factors in women with ACS. Future analysis incorporating menopausal hormone therapy data and adjustment for relevant covariates including age will provide further insights.

Publication Link

https://www.heartlungcirc.org/article/S1443-9506(25)01024-8/fulltext