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Menopause can have a significant impact on heart health, but many people don't realize this important connection.
Hormonal changes that occur during menopause mark the end of a woman’s reproductive years and increase the risk of cardiovascular disease, the leading cause of death among women worldwide. As estrogen levels decline, changes in cholesterol, blood pressure, inflammation, and fat distribution can lead to plaque buildup in blood vessels, a key factor in heart disease.
Hormone therapy has long been prescribed to relieve the unpleasant symptoms of menopause, but studies published in 2002 and 2004 raised concerns about its safety, particularly in the context of cardiovascular health. These findings have led to much confusion and debate. Although hormone therapy has also been used in the past to prevent chronic diseases such as cardiovascular disease, current medical guidelines no longer support its use for this purpose based on previous research.
As a cardiologist who focuses on cardiovascular disease prevention in menopausal women, I study how hormonal changes affect heart health and how treatments can be improved to reduce the risk of heart disease. With ongoing research shedding light on menopause and heart health, it is becoming increasingly clear that hormone therapy used to treat menopausal symptoms in young, healthy women is not only safe for the heart, but may even provide some cardiovascular benefits.
Explaining the Relationship Between Estrogen and the Cardiovascular System
Menopause, defined as 12 consecutive months without menstruation, ends a woman's reproductive years and typically occurs between the ages of 45 and 55. The transition period leading up to menopause, known as perimenopause, can last several years and is characterized by fluctuations in hormone levels, including estrogen and progesterone. These hormonal fluctuations often cause symptoms such as hot flashes, night sweats, and sleep disturbances.
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Less well known is that menopause and the decline in estrogen also lead to changes in the heart and blood vessels. Estrogen protects the cardiovascular system, and its decline can lead to increased stiffness of blood vessels, which in turn causes high blood pressure, elevated cholesterol, increased inflammation, and changes in fat distribution that increase the risk of heart disease.
One reason for this is that estrogen helps keep blood vessels elastic and promotes the production of nitric oxide, a molecule that allows blood vessels to relax and maintain normal blood flow. Estrogen also affects how the body processes cholesterol, promoting changes in cholesterol that reduce plaque buildup in artery walls. When estrogen levels drop during menopause, these protective effects are reduced, making arteries more susceptible to stiffening, plaque buildup, and inflammation. These biological processes increase the risk of long-term cardiovascular disease.
The complicated history of hormone therapy
Hormone therapy using estrogen alone or a combination of estrogen and progestin, a synthetic derivative of progesterone, restores estrogen levels and effectively relieves menopausal symptoms. However, it does come with some risks, depending on factors such as a woman’s age, time since menopause, and overall health.
The medical community's views on hormone therapy have changed significantly over the years. In the 1970s, hormone therapy
Sourse: www.livescience.com
