The relationships and independence of body composition, sex hormones, fat distribution and other cardiovascular risk factors were studied in 121 overweight postmenopausal women. Body composition and fat distribution were directly measured by dual energy X-ray absorptiometry (DXA); other parameters were waist-to-hip ratio (WTH), sex hormone binding globulin (SHBG), testosterone, androstenedione (A), oestradiol (E2), and lipids and lipoproteins; cigarette and alcohol consumption were recorded. SHBG was correlated with the fat distribution by DXA and WTH (r = -0.35, P < 0.01) and A with the fat mass (r = -0.3, P < 0.01). SHBG had a negative and alcohol and cigarette consumption a positive, independent relationship to a central fat distribution (by DXA and WTH, respectively) (P < 0.01). SHBG (r = 0.23, P < 0.05), fat distribution (WTH) and A (r = -0.2 to -0.3, P < 0.01) were correlated with high density lipoprotein cholesterol (HDL-C). However, only fat distribution (WTH) and A were independently related to HDL-C (P < 0.05). Fat distribution (WTH) and SHBG were independently related to triglycerides (P < 0.05), whereas fat distribution (by DXA) and E2 were independently associated with total cholesterol and low density lipoprotein cholesterol (LDL-C) (P < 0.05). Thus, in overweight postmenopausal women, androgenicity and cigarette and alcohol consumption were independently positively related to a central fat distribution. Furthermore, atherogenic levels of lipids and lipoproteins were independently related to a central fat distribution, androgenicity and low levels of oestrogens.