It is unclear how changes in ovarian hormones during the menopausal transition contribute to age-associated arterial stiffening. We sought to evaluate differences in arterial stiffness and the role of oxidative stress across the stages of the menopausal transition in healthy women.
Arterial stiffness (carotid artery compliance and ultrasound) was measured during immediate infusions of saline (control) and ascorbic acid (experimental model to immediately decrease oxidative stress) in 97 healthy women (22-70 y) classified as premenopausal (n = 24; mean [SD] age, 33  y), early perimenopausal (n = 21; 49  y) or late perimenopausal (n = 21; 50  y), or postmenopausal (n = 31; 57  y).
Basal carotid artery compliance was different among the groups (P < 0.001). Mean [SD] compliance was highest in premenopausal women (1.31 [0.25] mm2/mm Hg × 10−1), with progressive decrements in perimenopausal (early perimenopausal, 0.98 [0.31] mm2/mm Hg × 10−1; late perimenopausal, 0.90 [0.25] mm2/mm Hg × 10−1) and postmenopausal (0.75 [0.24] mm2/mm Hg × 10−1) women. Ascorbic acid infusion improved compliance in late perimenopausal (15% [18%] increase, P = 0.001) and postmenopausal (17% [26%] increase, P = 0.002) women but not in early perimenopausal or premenopausal women.
Arterial stiffening worsens across the stages of the menopausal transition in healthy women. This seems to be mediated, in part, by oxidative stress, particularly during the late perimenopausal and postmenopausal periods. It remains uncertain whether this is specifically caused by loss of ovarian function or aging.