# Physiologic and social stressors and health during menopausal transition

> **NIH NIH U54** · BRIGHAM AND WOMEN'S HOSPITAL · 2020 · $403,306

## Abstract

During perimenopause, women experience dramatic changes that extend beyond cessation of menses, including
alterations that accelerate the aging process and thereby elevate risks for cardiometabolic diseases, vascular
contributions to cognitive impairment and dementia (VCID), and Alzheimer’s disease (AD) pathology. Metabolic
risk factors that may emerge or worsen in the perimenopausal period include increases in central adiposity, blood
pressure, glucose, and non-HDL cholesterol, which are associated with later development of type 2 diabetes
mellitus, cardiovascular disease, and dementia. Many perimenopausal women also experience neuropsychiatric
changes including symptoms of vasomotor instability, sleep disturbance, depression, anxiety, and memory
problems, which represent major detriments to quality of life and may be important sex-specific risk factors for
cardiometabolic diseases and dementia caused by both VCID and AD. Numerous studies have characterized
genetic and behavioral risk factors for cardiometabolic diseases and dementia in middle adulthood. Less
attention has focused on physiologic and social stressors, which affect all body systems and heighten multiple
risk factors, as contributors to these diseases. Absolute risks differ by sex and lifestage: while premenopausal
women are at lower risk for CVD and dementia than men, risks increase dramatically through and after the
menopausal transition. Lifetime social stressors and physiologic stressors during reproductive transitions unique
to women may substantially account for the sex-specific risks of cardiometabolic diseases and dementia. Yet,
few studies have addressed these relationships in depth with prospective longitudinal follow-up. This Project will
test our overall hypothesis that perimenopausal women with higher exposure to social stressors throughout life
and physiological stressors during important reproductive transitions—pregnancy, the peripartum period, and
the perimenopause—will have greater cardiometabolic risk, more neuropsychiatric and cognitive symptoms, and
poorer sleep duration and quality. Highly prevalent exposures of interest include physiological stressors (excess
gestational weight gain, dysglycemia/gestational diabetes mellitus, elevated blood pressure/hypertensive
disorders of pregnancy, and excess postpartum weight retention) as well as social stressors (adverse childhood
events, exposures to racism and violence, and financial instability). Furthermore, we hypothesize that these
relations are mediated by adverse weight trajectories. To address these hypotheses, we will leverage Project
Viva, an ongoing, highly engaged cohort of women recruited in early pregnancy 1999–2002 (at mean age 32
years) and followed annually for almost 2 decades. This proposal provides an exceptional opportunity to inform
clinical care for aging women by leveraging outstanding existing data and resources and including over 20 years
of high- quality prospective assessments within a 5-ye...

## Key facts

- **NIH application ID:** 9854040
- **Project number:** 1U54AG062322-01A1
- **Recipient organization:** BRIGHAM AND WOMEN'S HOSPITAL
- **Principal Investigator:** Emily Oken
- **Activity code:** U54 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $403,306
- **Award type:** 1
- **Project period:** — → —

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9854040

## Citation

> US National Institutes of Health, RePORTER application 9854040, Physiologic and social stressors and health during menopausal transition (1U54AG062322-01A1). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9854040. Licensed CC0.

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