Menopause can have profound effects on heart health, yet many people are unaware of this important connection.
The hormonal shifts occurring during menopause mark the end of a woman’s reproductive years and contribute to an increased risk of cardiovascular disease, the most common cause of death among women globally blood pressure , inflammation and fat distribution can lead to plaque buildup in blood vessels
Hormone therapy has long been prescribed to relieve bothersome menopausal symptoms, but research published in 2002 2004 raised concerns years of confusion and debate no longer recommend it for this purpose
As a cardiologist studying the prevention of heart disease in menopausal women
Menopause, defined as 12 consecutive months without a menstrual period, marks the end of a woman’s reproductive years known as perimenopause
Hormone replacement safe and effective menopause treatment, study finds – YouTube
Watch On
What’s less widely known is that menopause and lack of estrogen also drive changes to the heart and blood vessels. Estrogen has protective effects on the cardiovascular system, and its decline can lead to increased blood vessel stiffness
Related: Women are at higher risk of dying from heart disease. Here’s why.
One reason for this is that estrogen helps keep blood vessels flexible supports the production of nitric oxide influences how the body processes these protective factors diminish
Hormone therapy using estrogen alone or a combination of estrogen and progestin, a synthetic derivative of progesterone, restores estrogen levels and effectively treats menopausal symptoms a woman’s age, time since menopause began and overall health
The medical community’s view on hormone therapy has shifted dramatically over the years. In the 1970s, hormone therapy was widely promoted as a fountain of youth prevent age-related chronic diseases
Then, in the early 2000s, the Women’s Health Initiative, one of the largest clinical trials testing oral hormone therapy in women, found an increased risk of stroke and breast cancer
However, additional analyses of data from the Women’s Health Initiative along with results from further studies pointed researchers to a theory called the timing hypothesis
According to the timing hypothesis, hormone therapy may lower the risk of heart disease in menopausal women who start it before age 60 and within 10 years of menopause onset
My research supports this idea. In a 2019 study, my colleagues and I analyzed data from 31 clinical trials of women who started hormone therapy at different ages
Additionally, research has shown that different methods of taking hormone therapy
This is due to a phenomenon called first pass metabolism into the bloodstream, bypassing the liver
Overall, we found that women who took oral hormone therapy tended to have lower cholesterol levels
However, hormone therapy is still not recommended
Medical experts now recognize that blanket recommendations for or against hormone therapy are not appropriate. Instead, treatment decisions should be individualized, considering factors such as age, time since menopause began and overall health.
If you are considering hormone therapy, discussing risks and benefits with your health care provider is vital.
Here are questions to consider asking your health care provider:
Am I a good candidate for hormone therapy based on my health history? What are the risks and benefits of starting hormone therapy at my age? What type of hormone therapy, such as pills, patches or gel, is safest and most effective for me? How long should I stay on hormone therapy? This edited article is republished from The Conversation under a Creative Commons license. Read the original article
