Fifty-two patients in premenopause (Group 1) and 86 women in early postmenopause (Group 2) were examined to study the specific features of the metabolic profile and arterial structural and functional status in women in different climacteric phases. The study participants' age in Groups 1 and 2 was 49.1 (48.0; 51.0) and 53.9 (50.0; 56.0) years, respectively. The duration of menopause was 3.5 (2.0; 5.0) years. Basic blood biochemical indicators were determined; studies of lipid metabolism and glucose tolerance tests were performed; the mean intima-media thickness (IMT) of the common carotid artery (CCA) was calculated; the vasoregulatory function of the brachial arterial endothelium was evaluated using ultrasound in a reactive hyperemia test. Most women in the early postmenopausal period were found to have unfavorable lipid and carbohydrate metabolic changes characteristic of metabolic syndrome. Lipid metabolic disturbances were detected in the women in premenopause, by reaching its highest magnitude in early postmenopause. The women in early postmenopause more commonly displayed higher CCA IMT values than the reference ones, atherosclerotic plaques in the carotid arteries, and more marked endothelial vasoregulatory dysfunction than those in premenopause. Endothelial functional activity evaluation and CCA IMT determination may be useful to allocate women to cardiovascular risk groups.