BOSTON—Women experiencing moderate-to-severe vasomotor symptoms face a three times greater risk for metabolic-dysfunction-associated steatotic liver disease (MASLD) compared to those with mild symptom severity, according to research being presented Monday at ENDO 2024, the Endocrine Society’s annual meeting in Boston, Mass.

Vasomotor symptoms include hot flashes or night sweats—symptoms that have become synonymous with menopause.

“This research is significant as it contributes to understanding the link between vasomotor symptoms and cardiometabolic risk factors,” said Eleni Armeni, M.D., M.Sc., Ph.D., a research fellow at the Second Department of Obstetrics and Gynecology, at Aretaieio Hospital National and Kapodistrian University of Athens, in Athens, Greece. “It is crucial for the general public because it emphasizes how hot flashes and night sweats can signal an increased risk for heart and metabolic issues.”

MASLD is also known as non-alcoholic fatty liver disease (NAFLD). In this cross-sectional study, researchers sought to analyze the likelihood of someone developing MASLD related to menopause and the potential link with vasomotor symptoms. 

“Women experiencing these symptoms should consult a health care professional to address the symptoms and assess their cardiovascular health,” Armeni said. “Previously, vasomotor symptoms were primarily seen as indicators of estrogen deficiency, but this study suggests broader implications for cardiovascular health related to this hormonal imbalance.”

Armeni and colleagues evaluated 106 peri- and postmenopausal women treated in an outpatient menopause clinic. They estimated steatotic liver disease (SLD) to determine the risk of the fatty liver index. The researchers accounted for age, exercise, alcohol, smoking, a history of menstrual irregularity, and hormone replacement therapy use.

The results showed that 42 women with moderate-to-severe vasomotor symptoms had a three times higher risk for MASLD compared with 64 women who had mild symptom severity. That risk was 9.3 times higher when they limited the sample to those who experienced symptoms within five years after the menopausal transition.

“We hope these findings will encourage health care providers to offer comprehensive care to peri- and postmenopausal women, going beyond discussions solely focused on hormone replacement therapy,” Armeni said. Armeni is scheduled to speak at the Society's reproductive health news conference at 11 a.m. Eastern June 2. Register to view the livestream at


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