MENOPAUSIA Y RIESGO CARDIOVASCULAR: DESMONTANDO EL REDUCCIONISMO HORMONAL PARA UNA MEDICINA VERDADERAMENTE PREVENTIVA
Authors/Creators
- 1. Universidad Libre – Seccional Cali; IPS Siloé Siglo XXI. Cali, Colombia
- 2. Universidad Santiago de Cali – Seccional Cali. Cali, Colombia
Description
Tipo de artículo: Carta al editor
La menopausia ha sido tradicionalmente interpretada como un evento biológico asociado principalmente al descenso de los niveles de estrógenos, lo que ha condicionado una visión reduccionista del riesgo cardiovascular en la mujer. Sin embargo, la evidencia científica actual indica que dicho riesgo responde a un proceso multifactorial en el que intervienen factores metabólicos, inflamatorios, vasculares y psicosociales, que se desarrollan de forma progresiva incluso antes del cese definitivo de la menstruación.
Esta carta al editor plantea una reflexión crítica sobre la necesidad de superar el enfoque exclusivamente hormonal, destacando que la menopausia debe entenderse como una etapa dentro del envejecimiento sistémico y no como un punto aislado de inicio del riesgo cardiovascular. Asimismo, se subraya la importancia de adoptar estrategias preventivas tempranas, integrales y basadas en la evidencia, que incluyan la evaluación del riesgo cardiometabólico, la promoción de estilos de vida saludables y la consideración de los determinantes sociales de la salud.
Finalmente, se advierte sobre los riesgos de la medicalización del envejecimiento femenino y del uso indiscriminado de terapias hormonales sin respaldo suficiente, proponiendo un cambio de paradigma hacia una medicina preventiva, equitativa y centrada en la salud integral de la mujer.
Abstract (English)
Article type: Letter to the editor
Menopause has traditionally been interpreted as a biological event primarily associated with declining estrogen levels, which has led to a reductionist view of cardiovascular risk in women. However, current scientific evidence indicates that this risk is multifactorial, involving metabolic, inflammatory, vascular, and psychosocial factors that develop progressively even before the final cessation of menstruation.
This letter to the editor offers a critical reflection on the need to move beyond an exclusively hormonal approach, emphasizing that menopause should be understood as a stage within systemic aging rather than an isolated trigger of cardiovascular risk. It also highlights the importance of adopting early, comprehensive, and evidence-based preventive strategies, including cardiometabolic risk assessment, promotion of healthy lifestyles, and consideration of social determinants of health.
Finally, the manuscript warns about the risks associated with the medicalization of female aging and the indiscriminate use of hormonal therapies without sufficient evidence, advocating for a paradigm shift toward preventive, equitable, and holistic women’s health care.
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Additional details
Additional titles
- Translated title (English)
- MENOPAUSE AND CARDIOVASCULAR RISK: DISMANTLING HORMONAL REDUCTIONISM FOR A TRULY PREVENTIVE MEDICINE
Dates
- Collected
-
2026-01-07manuscrito recibido
- Accepted
-
2026-02-04Dirección editorial
- Available
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2026-04-29publicación en numero de la revista
Software
- Repository URL
- https://revistacientificasanum.com/
References
- 1- El Khoudary SR, Aggarwal B, Beckie TM, et al; American Heart Association Prevention Science Committee of the Council on Epidemiology and Prevention; and Council on Cardiovascular and Stroke Nursing. Menopause transition and cardiovascular disease risk: implications for timing of early prevention: A scientific statement from the American Heart Association. Circulation. 2020;142(25):e506-e532. doi:10.1161/CIR.0000000000000912 2- Ryczkowska K, Adach W, Janikowski K, Banach M, Bielecka-Dabrowa A. Menopause and women's cardiovascular health: is it really an obvious relationship? Arch Med Sci. 2022;19(2):458-466. doi:10.5114/aoms/157308 3- Shen X, Wang C, Zhou, X, et al. Nonlinear dynamics of multi-omics profiles during human aging. Nat Aging. 2024;(4):1619-1634. doi:10.1038/s43587-024-00692-2 4- Thurston RC, Aslanidou Vlachos HE, Derby CA, et al. Menopausal vasomotor symptoms and risk of incident cardiovascular disease events in SWAN. J Am Heart Assoc. 2021;10(3):e017416. doi:10.1161/JAHA.120.017416 5- Dastmalchi LN, Gulati M, Thurston RC, et al. Improving cardiovascular clinical competencies for the menopausal transition: a focus on cardiometabolic health in midlife. JACC Adv. 2025;4(6 Pt 2):101791. doi:10.1016/j.jacadv.2025.101791