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Lipid Management in Endocrine Disorders

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15 9. Polycystic Ovary Syndrome Lipid Abnormalities ➤ 9.1 In women with polycystic ovary syndrome (PCOS), we recommend obtaining a fasting screening lipid panel at diagnosis to assess CV risk. (1|⊕⊕⊕ ) Technical Remarks: ▶ PCOS is associated with CV risk factors. ▶ Conduct lipid screening both before and intermittently during hormonal therapy. ▶ In PCOS, hypertriglyceridemia is the most common lipid abnormality. Cardiovascular Risk Effect of treatment of PCOS on lipids ➤ 9.2 In women with PCOS, we suggest against using lipid-lowering therapies to treat hyperandrogenism or infertility. (2|⊕ ) 10. Menopause And Hormonal Replacement ➤ 10.1 In postmenopausal women, we recommend treating dyslipidemia with statin therapy, rather than hormone therapy. (1|⊕⊕ ) Technical Remarks: ▶ Hormone therapy increases the risk of CVD, specifically venous thromboembolism and stroke. However, the absolute risk of CVD is lower in younger compared to older postmenopausal women. ▶ Hormone therapy is described as estrogen +/– progesterone/a progestin. ➤ 10.2 In postmenopausal women on hormone therapy and with other risk factors for CVD, we recommend statin therapy to reduce CV risk. (1|⊕⊕⊕⊕) Technical Remarks: ▶ Hormone therapy increases the risk of CVD, specifically venous thromboembolism and stroke. However, the absolute risk of CVD is lower in younger compared to older postmenopausal women. ▶ Hormone therapy is described as estrogen +/– progesterone/a progestin. ▶ Menopause may be associated with an increase in LDL-C and a decrease in HDL-C. ▶ Risk factors may be traditional risk factors or risk-enhancing factors. ➤ 10.3 In women who enter menopause early (<40–45 years old), we recommend assessment and treatment of lipids and other CV risk factors. (1|⊕⊕⊕ ) Technical Remarks: ▶ Early menopause enhances CVD risk. ▶ ASCVD risk should be calculated and followed after menopause.

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