JCL roundtable: Cardiovascular disease risk reduction in menopausal women.

Ovarian failure occurs in most women during the late fifth decade or early sixth decade of life. This causes a number of changes in physiology as estrogen and progestin concentrations decline. These involve lipoprotein metabolism and the vasculature. The risk factors for large vessel disease increase, and dysfunction of the small resistance vessels responds with changes in blood flow to the skin causing unpleasant symptoms. These and other changes result in visits to the physician. A reassessment of risk factors and symptoms is needed to develop a new plan for effective management, both short term and long term.