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Semin Reprod Med
DOI: 10.1055/s-0045-1811965
Review Article

Reproductive History and Cardio-Metabolic Risk in the Postmenopausal Age

Authors

  • Laura Cucinella

    1   Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
    2   Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS S. Matteo Foundation, Pavia, Italy
    3   Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy

  • Anna Odone

    3   Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
    4   Medical Direction, IRCCS S. Matteo Foundation, Pavia, Italy

  • Rossella E. Nappi

    1   Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
    2   Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS S. Matteo Foundation, Pavia, Italy

Funding None.
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Abstract

Menopause represents a cardio-metabolic transition, but cardiovascular (CV) health in women is highly influenced by other reproductive milestones and conditions, which delineate a cardio-reproductive lifeline. Reproductive history represents an opportunity to identify women at elevated risk of CV events after menopause, going beyond traditional CV risk factors. This review aims to summarize the impact of reproductive milestones, gynecological conditions, and pregnancy-related factors on cardio-metabolic health at midlife. The main physio-pathological mechanisms likely implicated in linking reproductive events and CV disease risk are described, as well as the impact of specific conditions (early/late menarche and menstrual dysfunction [functional hypothalamic amenorrhea, polycystic ovary syndrome, benign gynecological conditions (endometriosis, adenomyosis, and fibroids), infertility, adverse pregnancy outcomes, and premature/early natural or surgical menopause]). Data indicate that a reproductive checklist in midlife women is warranted for primary prevention and intervention.

Keywords

menopause - cardiovascular disease - reproductive history - adverse pregnancy outcomes - menstrual dysfunction

Authors' Contributions

All authors participated in writing the manuscript and have seen and approved the submitted version.




Publication History

Article published online:
30 September 2025

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