1 3 J Endocrinol Invest DOI 10.1007/s40618-015-0253-3 ORIGINAL ARTICLE Surgical menopause versus natural menopause and cardio-metabolic disturbances: A 12-year population-based cohort study M. Farahmand · F. Ramezani Tehrani · M. Bahri Khomami · M. Noroozzadeh · F. Azizi Received: 9 August 2014 / Accepted: 3 February 2015 © Italian Society of Endocrinology (SIE) 2015 Introduction Life expectancy has increased in women; about 95 % of women in industrialized countries spend over a third of their lives in the postmenopausal period [1, 2]. Nowadays, many women continue their lives 20–30 years after meno- pause [3]. The risk of cardiovascular disease (CVD), the first cause of mortality among women, increases after the menopause [4–6]. It is estimated that 25 % of cardiovas- cular events in women are related to the metabolic syn- drome (MetS) [7]. Results of studies on the relationship between MetS and menopause differ. A number of stud- ies report relationships between menopause and risk fac- tors for MetS components [8]. A study in Latin America showed that factors such as age, lifestyle, and age at men- opause were associated with risk of MetS in postmeno- pausal women [9]. Changes in lipoprotein levels after menopause are risk factors for CVD [10–13]. Aging also causes changes in lipoproteins profile [14]; the relationship between these changes that occur following cessation of ovarian hor- mones and the menopausal process is not yet clear [13, 15, 16]. Cessation of ovarian hormones, following natural and surgical menopause, occurs gradually and suddenly, respectively [17, 18]. Metabolic changes following surgi- cal and natural menopause differ [19] and are associated with the risk factors for CVD [20]. Moreover, several other factors such as race and lifestyle affect metabolic disorders [21]. Therefore, a prospective population-based study was designed to compare metabolic changes in the two groups of naturally and surgically menopausal women in two periods, 3 years before and after menopau- sal occurrence. Abstract Purpose Menopausal status exposes women to increased risk of cardiovascular disease. This study was performed to compare the effect of menopausal types, including surgical and natural, on metabolic syndrome and other metabolic disorders 3 years before and after menopause. Methods Of 437 postmenopausal women, who partici- pated in the Tehran Lipid and Glucose Study, 13 women with surgical menopause and 39 age-matched controls with natural menopause were selected. During the follow-up period, changes in metabolic and biochemical profiles were compared between surgical and natural menopause women. Results Odds of incidence of metabolic syndrome in sur- gical menopause women, compared to natural menopause women, was 9.7 (95 % CI 1.8–51.8). Conclusions Metabolic disturbances after menopause are highly influenced by type of menopause and are more prev- alent in those undergoing surgical menopause. Keywords Natural menopause · Surgical menopause · Metabolic syndrome · Tehran Lipid and Glucose Study M. Farahmand · F. Ramezani Tehrani (*) · M. Bahri Khomami · M. Noroozzadeh Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, 24 Parvaneh St., Yaman St., Velenjak, PO Box 19395-4763, Tehran, Islamic Republic of Iran e-mail: ramezani@endocrine.ac.ir; framezan@post.harvard.edu M. Farahmand e-mail: mfarahmand14@yahoo.com F. Azizi Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, 24 Parvaneh St., Yaman St., Velenjak, PO Box 19395-4763, Tehran, Islamic Republic of Iran