Postmenopausal transition is strongly associated with an increased burden of cardiovascular disease, largely driven by hormonal decline and metabolic dysregulation. This experimental study aimed to evaluate the interplay between hormonal regulation and metabolic dysfunctions contributing to cardiovascular risk in postmenopausal women compared with premenopausal controls. A total of 180 participants were divided into three groups: premenopausal healthy controls, postmenopausal women without metabolic syndrome, and postmenopausal women with metabolic syndrome. Serum estrogen, follicle-stimulating hormone, lipid profile, fasting glucose, insulin resistance index, and inflammatory markers were assessed. Cardiovascular risk was evaluated using carotid intima-media thickness and Framingham risk score.

Results demonstrated a statistically significant reduction in estrogen levels (p<0.001) and elevation in FSH in postmenopausal groups. Dyslipidemia, insulin resistance, and inflammatory biomarkers were markedly higher in postmenopausal women with metabolic syndrome (p<0.001). Carotid intima-media thickness showed significant progression in high-risk postmenopausal participants, correlating strongly with estrogen depletion (r=0.62, p<0.01). The findings indicate that hormonal decline acts synergistically with metabolic impairment to accelerate subclinical atherosclerosis.

The study concludes that postmenopausal cardiovascular risk is driven by integrated hormonal-metabolic dysfunction rather than isolated endocrine changes, highlighting the need for early biomarker-based risk stratification and targeted metabolic-hormonal intervention strategies in postmenopausal populations..