Hormone Therapy and Heart Health

Heart disease is the #1 killer of women.  In order to be your own best health advocate, it is essential to keep up on the latest info and studies.

Since the WHI (Women’s Health Initiative)  hoopla in 2002, there has been lots of confusion about heart health and HT (hormone therapy). Remember, part of the issue with the first reporting of the study as it related to cardiovascular health is that women who had previously experienced heart problems had not be excluded in the study.  Many of the women were over 60 years old and already had heart conditions…………therefore, the initial reporting in 2002 was not really helpful to us heart healthy women. Grrrrrrrrrrrrrrrrrrrr!

However, there has been new critically important studies since 2002. It is important to keep up!  Let’s recap what the current consensus is about HT and heart health:

• Currently, the benefits of estrogen and heart health are universally accepted.
• Estrogen has rapid beneficial vascular effects on heart health.
• The shorter periods between the onset of menopause (Remember, you have graduated to menopause when you have been without a period for 12 consecutive months.) and the initiation of HT,  the greater protection a woman has against cardiovascular disease.

Let’s recap about what we know about The Danish randomized control study:

• This study tested whether hormone therapy can reduce cardiovascular endpoints in women if started early after menopause. The conclusion:  “After 10 years of randomized treatment, women receiving hormone replacement therapy early after menopause had a significantly reduced risk of mortality, heart failure, or myocardial infarction, without any apparent increase in risks of cancer, venous thromboembolism, or stroke.”
• According to Dr. JoAnn Pinkerton, the Executive Director of the North American Menopause Society and Professor of Ob-Gyn at the University of Virginia, “The decline in estrogen may be a factor in the increased heart disease seen in postmenopausal women. There may be a critical window of timing with the heart in that women within 10 years of menopause benefit from estrogen. Those who are older with already developed atherosclerotic plaque may be worsened with estrogen. Estrogen may decrease total cholesterol, decrease plaque formation or improve the inner layer of the artery wall.”
• You might find this interesting as well. This study that looked at women who have had a hysterectomy and were NOT put on estrogen therapy (ET).  (Hysterectomized women do not need progesterone therapy.)  ET in younger postmenopausal women is associated with a decisive reduction in all-cause mortality. 

It is important to note that not only is HT beneficial to our heart health, but it also has protective benefits for bone health, vaginal health, VSM prevention, joint and muscle pain, mood changes, and sleep disturbances for women under the age of 60 or within 10 years of menopause.

This new study reported at NAMS was done to see what happens to a woman’s arterial function if she discontinues her HT and is age 60 or under. Here is what they reported about this new Finnish study which involved more than 400,000 women with no prior cardiac or stroke events:

•  “The discontinuation of HT was associated with an increased risk of cardiac and stroke death during the first post-treatment year, especially in women who discontinued HT aged younger than 60 years. This increased risk was not observed in women aged 60 years or older at the time of discontinuation.”
• Dr. JoAnn Pinkerton, NAMS Executive Director further explained, “Since the initial Women’s Health Initiative reports, studies have shown that hormone therapy has many benefits and is safer than originally thought. This is especially true for symptomatic menopausal women younger than age 60 and within 10 years of menopause, as these women had fewer heart events and less risk of mortality. This new study suggests that younger women may have a higher risk of heart disease and stroke during the first year of discontinuation. Thus, women and their healthcare providers need to consider the benefits and risks of starting and stopping hormone therapy before making any decisions.”

If you are thinking of discontinuing your HT before the age of 60…………….please take this information in with you to your Menopause Specialist and have a serious conversation with about what age you should stop your treatment.   If you don’t have a Menopause Specialist, here are some tips on how to find one!

Remember:  Suffering in silence is OUT!  Reaching out is IN.

For more great tips on how to find a menopause specialist and deal with menopause, download my free eBook: MENOPAUSE MONDAYS  the Girlfriend’s Guide to Surviving and Thriving During Perimenopause and Menopause.

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