Perimenopause as an obesogenic sensitive period: Contributions to elevated cardiovascular risk.
Level 4 - case-series / case-control
Single clinical case report
PubMed 41567597 · doi:10.1016/j.ajpc.2025.101398
What was done
A clinical case report evaluating a 46-year-old woman with schizoaffective disorder and treated hypothyroidism who presented with oligomenorrhea, vasomotor symptoms, and progressive weight gain within one year of starting monthly extended-release aripiprazole lauroxil injections. Physical examination, endocrine laboratory workup, medication discontinuation, and more than two years of follow-up with lifestyle changes were evaluated.
What was found
The patient gained 9.2 kg, shifting into an overweight body mass index, with centripetal fat distribution. Laboratory testing showed elevated follicle-stimulating hormone, undetectable anti-Müllerian hormone, normal thyroid-stimulating hormone, normal prolactin, normal 24-hour urine free cortisol, and negative human chorionic gonadotropin. Discontinuing aripiprazole lauroxil alongside diet and exercise interventions did not lead to significant weight loss over more than two years of follow-up.
Why it matters
This report suggests that perimenopause may represent a window of heightened metabolic susceptibility where medications with mild-to-moderate obesogenic risk can trigger pronounced and persistent visceral weight gain.
Limits
As an uncontrolled single-patient case report (n=1), causality between the medication, perimenopause, and irreversible weight gain cannot be established. Body composition was assessed via physical examination rather than direct imaging, and lifestyle interventions were self-reported.
Cited by
- supports Perimenopause is associated with an 8 to 10% annual increase in visceral fat.