A Multidisciplinary Approach to VMS and Cardiovascular Health

In the final episode, "A Multidisciplinary Approach to VMS and Cardiovascular Health," the panelists explore how effective, team-based care across specialties can optimize health outcomes for women navigating the menopausal transition, and offer closing reflections on the evolving landscape of VMS and cardiovascular risk management.

Dr. Erin Michos describes the multidisciplinary menopause program at their institution as a model for coordinated care, where gynecologists and menopause clinicians serve as the first line of cardiovascular risk identification — screening for adverse pregnancy outcomes, family history, and other risk markers — before referring higher-risk patients to cardiology for more comprehensive evaluation, including advanced lipid testing such as lipoprotein(a) and apolipoprotein B. Additional specialist referrals, including bone health, neurology, gastroenterology, and psychiatry, are made based on each patient's individual constellation of symptoms and risk factors. The experts emphasize that this collaborative model should extend to primary care, which often serves as a patient's first point of contact, and that clear lines of communication across disciplines are essential.

Dr. Kristi DeSapri reinforces that menopause represents a total-body transition requiring a well-rounded, team-based approach, and encourages clinicians to pursue proactive menopause education, listen carefully to patients, and match treatment — hormonal or non-hormonal — to each woman's individual needs and risk profile.

An important clinical clarification is offered by Dr. Michos: while VMS are associated with increased cardiovascular risk, treating VMS with hormone or non-hormonal therapy does not necessarily prevent cardiovascular events. Rather, VMS may serve as a marker identifying women with an underlying unfavorable cardiometabolic profile who warrant timely preventive intervention targeting lipids, blood pressure, and insulin resistance. Both panelists agree that cardiovascular prevention ideally begins well before menopause — even during the reproductive years — so that women enter the menopausal transition in the best possible cardiometabolic health.

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