Epidemiology
Menopause raises Lp(a) by 3.77 mg/dL, though ageing itself cannot be ruled out as the driver, a meta-analysis spanning 12,960 women (Maturitas 2023)
Original title: The effect of menopause on lipoprotein (a) concentrations: A systematic review and meta-analysis
This systematic review and meta-analysis (search through 8 March 2022) pooled 17 studies qualitatively and 15 quantitatively, covering 4,686 premenopausal and 8,274 postmenopausal women. Lp(a) was lower in premenopausal than postmenopausal women (WMD -3.77 mg/dL, 95% CI -5.37 to -2.18, P<0.001, I2=99%), a difference that persisted when restricted to 9 good-quality studies. However, 4 studies comparing age-matched pre- and postmenopausal women found no significant difference (WMD -1.22 mg/dL, 95% CI -3.15 to 0.72), and 3 studies comparing women before and after bilateral oophorectomy also found no difference (WMD -3.38 mg/dL, 95% CI -7.29 to 0.54, P=0.09). The findings suggest menopausal transition may raise Lp(a), but the confounding effect of ageing cannot be excluded from current evidence.
Original abstract
Objective: Transition to menopause has been associated with an increased risk of cardiovascular disease (CVD), attributed mainly to atherogenic dyslipidemia. Whether lipoprotein (a) [Lp(a)], an independent cardiovascular risk factor, also contributes to menopause-associated CVD has not yet been clarified. The aim of this study was to systematically investigate and meta-analyze the best available evidence regarding the effect of menopause on Lp(a) concentrations.
Methods: A comprehensive search was conducted in PubMed and Scopus databases up to March 8th, 2022. Data were expressed as weighted mean difference (WMD) with 95 % confidence intervals (CI). The I2 index was employed to assess heterogeneity.
Results: Seventeen studies were included in the qualitative and 15 in the quantitative analysis, yielding 4686 premenopausal and 8274 postmenopausal women. Lp(a) concentrations were lower in premenopausal than in postmenopausal women [WMD -3.77 (95 % CI -5.37, -2.18) mg/dl, p < 0.001; I2 99%, p < 0.001]. This difference was maintained when the analysis was restrained to good-quality studies (n = 9). Four studies included pre- and postmenopausal women, matched for age, and these found no difference in Lp(a) concentrations between groups [WMD -1.22 (95 % CI -3.15, 0.72) mg/dl, p < 0.001; I2 99%, p < 0.001]. Three studies provided data for Lp(a) in women before and after bilateral oophorectomy, and these found no difference between them [WMD -3.38 (95 % CI -7.29, 0.54) mg/dl, p = 0.09; I2 0%, p < 0.44].
Conclusions: Transition to menopause may increase Lp(a) concentrations, although the effect of aging cannot be excluded by current data.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.