Menopause
Study offers new insights into link between menopause and cardiovascular health

Post-menopausal women show higher cholesterol even in populations with the world’s healthiest hearts, suggesting menopause affects cardiovascular health everywhere.
Researchers studying the Tsimane, a forager-horticultural community in the Bolivian Amazon with exceptionally low heart disease rates, found their post-menopausal women had rises in blood lipids – fats in the blood such as cholesterol that contribute to heart disease.
Five of the six measured factors, including triglycerides, total cholesterol and low-density lipoprotein (LDL) cholesterol, were 1.5 to 11 per cent higher after menopause in Tsimane women.
DL cholesterol, often known as “bad cholesterol”, can build up in artery walls and increase heart attack risk.
The research team from Arizona State University had expected different results given the Tsimane’s unusually healthy cardiovascular systems and lifestyle.
Madeleine Getz is a PhD student in global health at ASU’s School of Human Evolution and Social Change and lead author.
She said: “While we have good data from industrialised populations, to our knowledge, nobody had looked at this relationship in a non-industrial, highly active population like the Tsimane before.
“To see these risk factors increase after menopause in this population, despite their incredibly low levels of heart disease, was unexpected.”
The Tsimane live a traditional hunter-farmer lifestyle with diets free of processed foods and very high physical activity, averaging 15,000 to 20,000 steps a day.
Previous studies have shown they have the lowest dementia rates and healthiest hearts of any population studied.
Despite their lifestyle, the cholesterol rise after menopause mirrored that seen in industrialised nations, though at much lower levels.
The increases were two to seven times smaller than those recorded in the US and UK.
“This suggests that these increases in cholesterol around menopause may be a human universal, no matter how or where we live,” Getz said.
Benjamin Trumble, senior author and professor at ASU’s School of Human Evolution and Social Change, co-directs the Tsimane Health and Life History Project, which has worked with the community for more than 20 years.
“Working with populations like the Tsimane allows us to see global variation in both menopause and human health,” Trumble said.
“The findings here suggest that menopause is associated with increased risk factors for heart disease, even in the population with the healthiest hearts in the world.
“That suggests that post-menopausal increases in heart disease may be a human universal, and part of our underlying physiology regardless of lifestyle choices.”
The findings indicate that hormonal changes during menopause affect cardiovascular health regardless of lifestyle.
In industrialised nations, women face increased heart disease risk after menopause, when oestrogen levels fall.
News
Government and NHS urged to work with pharmacies on menopause support

The government and NHS England should work with pharmacies to show how the sector can help women experiencing menopause symptoms, according to a joint statement released by several pharmacy bodies.
A consensus statement endorsed by the Royal College of Pharmacy warned there remains significant unmet need for clear, evidence-based guidance and advice on the condition.
The statement, ‘Menopause, unmissed’, published on 24 April 2026, was endorsed by bodies including the Royal College of Pharmacy, the Company Chemists’ Association and the National Pharmacy Association.
Amandeep Doll, director for England at the Royal College of Pharmacy, said: “Pharmacy teams are highly accessible and already support people experiencing menopause with advice, self-care and signposting to other services.
“We endorsed this statement because improving access to clear information and joined-up care is essential, particularly for those facing inequalities.”
According to the NHS, around 75 per cent of women experience some symptoms during perimenopause and menopause, while 25 per cent report that their symptoms are severe.
In the joint statement, the pharmacy bodies welcomed increased awareness of menopause in recent years but warned this had also led to a sea of misinformation and that there remains significant unmet need, particularly for clear, evidence-based and accessible information and guidance.
The document set out eight recommendations to improve menopause care, including a public awareness campaign on menopause symptoms and opportunities for self-care, alongside guidance on how pharmacies can support women with menopause.
It also recommended that integrated care boards and women’s health hubs should report progress on implementing the upcoming equity framework in menopause care.
In its renewed women’s health strategy for England, published on 15 April 2026, the Department of Health and Social Care set out plans to publish an equity good practice guide to help integrated care boards better understand and reduce inequalities in heavy periods and menopause.
The joint statement asked that the Department of Health and Social Care and NHS England work with champions in minority communities to ensure menopause materials reflect a diverse range of experiences.
It added that women living in areas of high deprivation and those from Black, Asian and minority ethnic communities can experience menopause differently and are more likely to face health inequalities in their care.
Doll said: “With the right support, training and commissioning, community pharmacy can play a greater role in delivering timely, convenient menopause care closer to home, working as part of neighbourhood health teams and in partnership with women’s health hubs.”
News
HRT maker censured by regulators for ‘systemic failures’ that risked patient safety

Theramex has been censured over HRT failures that regulators said jeopardised patient safety.
The UK producer of HRT drugs, including Evorel and Intrarosa, was found to have breached fundamental compliance standards.
These included not updating crucial prescribing information, in some cases for several years, and not making clear that one drug must not be used during pregnancy.
The Prescription Medicines Code of Practice Authority issued the public reprimand after Theramex staff blew the whistle over what it described as “alarming” compliance issues and incomplete prescribing information for Evorel and Intrarosa that “jeopardise patient safety”.
Evorel patches, which contain estradiol, are among the most prescribed forms of transdermal HRT, meaning hormone treatment delivered through the skin. More than 250,000 items were issued in the last financial year, according to NHS Business Services Authority figures.
Overall, nearly 10m items of estradiol, including gels, were prescribed in the 2024/25 financial year.
The employees’ concerns included failing to provide comprehensive side-effect information in Evorel’s prescribing information, and not updating Intrarosa’s product information since 2019.
The PMCPA also reprimanded the company over failures to specify in advertising at a reproduction and advertising conference that Yselty, used to treat uterine fibroids, should not be taken during pregnancy.
In total, the PMCPA found Theramex had breached the Association of the British Pharmaceutical Industry’s code of practice 21 times.
The panel said the breaches not only jeopardised patient safety, but that Theramex had “brought discredit upon, and reduced confidence in, the pharmaceutical industry”.
The PMCPA also condemned Theramex’s decision to leave the regulator’s jurisdiction.
“By leaving the self-regulatory framework and requiring the Medicines and Healthcare products Regulatory Agency to assume full responsibility for regulating it, Theramex has inevitably delayed any regulatory action and oversight,” it said.
Dr Amit Aggarwal, medical director of the ABPI, said: “Theramex has fallen seriously short of the standards expected under our strict ABPI code of practice, and it’s right that the PMCPA took action.
“It’s also disappointing that as a result, the company has decided to leave the pharmaceutical industry’s self-regulatory system, which holds companies to standards above and beyond the law.”
Julian Beach, MHRA’s executive director of healthcare quality and access, said he was disappointed Theramex had left the PMCPA, but that the MHRA would take any necessary steps to ensure patient safety.
He said: “Leaving the jurisdiction of the PMCPA does not mean a company escapes scrutiny.
“The MHRA has legal powers to investigate and act on concerns about medicines that may impact public safety. Breaches of regulations can amount to criminal offences.”
A spokesperson for Theramex said: “Upholding ethical standards, compliance, and patient safety is very important to us. We acted promptly to address these historical matters as soon as we became aware of them.
“We take these matters seriously and have undertaken a comprehensive review of our compliance framework, including commissioning an independent external audit and implementing a broad programme of enhancements.
“As part of this process, we concluded it is most appropriate to be regulated with respect to UK medicines legislation by the MHRA, while continuing to uphold the spirit and principles of the EFPIA and ABPI codes of practice.
“Therefore, we withdrew from the PMCPA’s jurisdiction in January 2026. This approach allows us to focus our resources on maintaining high standards of ethical and compliant behaviour, with patient safety.”
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