Recognizing the Bidirectional Risk of Menopause and Diabetes, with Erin Michos, MD

Published on: 

During a presentation at the Metabolic Insitute of America's 7th Heart in Diabetes meeting, Erin Michos, MD, broke down the importance of recognizing the bidirectional risk between diabetes and menopause.

The death of Tori Bowie, US Olympic champion sprinter, has thrust the topic of women’s health into spotlight across the US.

According to the Associated Press, the office of the medical examiner in Orlando, Florida, said Bowie was estimated to be 8 months pregnant and showing signs of undergoing labor when she was discovered dead on May 2. Per the same report, the autopsy report concluded died from complications of childbirth.1

With the seriousness of some conditions or complaints of symptoms often ignored, overlooked, or underrecognized, improving the health of women has been a persistent hurdle for US health care systems.

At The Metabolic Institute of America’s 7th Heart in Diabetes meeting, Erin Michos, MD, director of Women's Cardiovascular Health Research and the associate director of Preventive Cardiology at the Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, led a discussion an overlooked and underrecognized aspect of health for aging women: the bidirectional risk of menopause and diabetes.

Michos opened her presentation by calling immediate attention to the metabolic changes associated with menopause, which she noted should not be viewed as disease and recognized as a natural transition all women who reach a certain age will experience in their lifespans. After detailing how changes in hormones and body composition associated with the cessation of menses can increase overall cardiometabolic risk, Michos spent time elucidating the bidirectional risk of menopause and diabetes by recalling data from the Rotterdam study, Dongfeng-Tongji cohort study, and the Women’s Health Initiative.2,3,4

During her presentation, Michos dedicated time to highlighting the importance of recognizing the risks associated with vasomotor menopause symptoms and she supported this with data from the SWAN study, which concluded women reporting vasomotor symptoms in more than 33% of visits had a 77% greater risk of incident cardiovascular than their counterparts reporting symptoms in 0-33% of visits.5

During our coverage of the meeting, our editorial sat down with Michos at Heart in Diabetes to learn more about the current state of awareness of this risk, the importance of recognizing risks associated with onset of vasomotor menopausal symptoms, and potential direction of future research on the topic.

Disclosures of note for Erin Michos, MD, MHS, include Esperion, Amgen, Novartis, and others. Click here for a full list.


  1. Olympic sprinter Tori Bowie died from complications of childbirth, autopsy report concludes. AP NEWS. June 13, 2023. Accessed June 14, 2023.
  2. Muka T, Asllanaj E, Avazverdi N, et al. Age at natural menopause and risk of type 2 diabetes: a prospective cohort study. Diabetologia. 2017;60(10):1951-1960. doi:10.1007/s00125-017-4346-8
  3. Shen L, Song L, Li H, et al. Association between earlier age at natural menopause and risk of diabetes in middle-aged and older Chinese women: The Dongfeng-Tongji cohort study. Diabetes Metab. 2017;43(4):345-350. doi:10.1016/j.diabet.2016.12.011
  4. LeBlanc ES, Kapphahn K, Hedlin H, et al. Reproductive history and risk of type 2 diabetes mellitus in postmenopausal women: findings from the Women's Health Initiative. Menopause. 2017;24(1):64-72. doi:10.1097/GME.0000000000000714
  5. Thurston RC, Aslanidou Vlachos HE, Derby CA, et al. Menopausal Vasomotor Symptoms and Risk of Incident Cardiovascular Disease Events in SWAN. J Am Heart Assoc. 2021;10(3):e017416. doi:10.1161/JAHA.120.017416