Hormone Replacement Therapy Not Harmful to Heart Health for Women in Perimenopause

Researchers at the Phoenix VA Healthcare System have found that healthy women in perimenopause may be able to take hormone replacement therapy (HRT) without causing harm to their hearts. Experts from the widely known Women’s Health Initiative had previously thought that HRT would harm the heart in some way. However, many of those women were found to be much older than the ones experiencing symptoms of menopause. Doctors initially expected estrogen to reduce the progression of heart disease. However, their research was unable to support, nor disprove, their initial claims. For the time being, the research does say that women can use estrogen as a way to treat common menopausal symptoms like hot flashes and night sweats without direct harm to their heart health. Because oral estrogen has been found to have a prothrombotic effect, transdermal delivery may also be better for women with existing risk CVD risk factors. No effect on blood pressure was noted with the low-dose KEEPS regimens, in contrast to the Women’s Health Initiative in 2002, which showed modest increases in systolic blood pressure with higher-dose therapy in older women.  It is interesting to note, that although the investigators found few differences among groups for build-up of plaque and other markers of heart disease risk they did find:  The oral dose group had decreased levels of LDL (“bad”) cholesterol and increased HDL (“good”) cholesterol. But they also had increased triglycerides, another type of blood fat that may increase the risk of heart disease. The study findings point to the need to individualize decisions on hormone replacement therapy based on each person’s risk factor. For instance, if a woman has a family history of heart disease, high LDL and bothersome symptoms, HRT might be prescribed. The good news? “It doesn’t hurt either,” Dr. S. Mitchell Harman, chief of the endocrine division and interim chief of medicine at the Phoenix VA Healthcare System said. “It looks like a wash.” So, for women who are affected by the common menopausal symptoms of hot flashes and night sweats, taking hormone replacement therapy for a few years doesn’t appear to jeopardize heart health, he said, at least in this healthy group of women.

Researchers Review the Literature on Gender Gap in Deaths from AMI(Acute Myocardial Infarction)

Researchers at Yale University School of Medicine recently reviewed 50 years of medical research to determine why there are more women that die of acute myocardial infarction (AMI). An acute myocardial infarction is a type of heart attack that occurs when part of the heart is blocked for a period of time, causing pieces of the heart muscles to become damaged or die. No other study has compared the results of long term mortality post AMI in both women and men. Dr Noel Bairey Merz (Cedars-Sinai Medical Center, Los Angeles, CA), highlights an even bigger challenge.  She says that having clinicians take sex differences seriously and incorporate any opportunities to mitigate these differences into daily practice.  “Existing diagnostic AMI and CHD strategies developed in men, for men, and by men fail to diagnose approximately 20% to 30% of women with ischemic heart disease,” she writes. It’s high time physicians start closing the AMI diagnosis and outcomes gap between men and women, without waiting for new research by incorporating “the well-documented non–chest-pain symptoms into emergency-department and outpatient suspected ACS/AMI protocols,” Bairey Merz told heartwire.

Latest Research from the Largest Study on Caffeine and Post-Menopausal Women

Are hot flashes and night sweats keeping you from your living your life? Researchers at the Mayo Clinic recently published a study in the journal, Menopause, showing a connection between caffeine intake and symptoms of menopause. This is the largest study, to date, on the subject of caffeine and menopause. Surprisingly, the study also showed a correlation between caffeine intake and less problems with mood, memory, and concentration. This is likely due to the fact that caffeine enhances concentration, mood, and arousal in women in perimenopause.

Two Hormone Therapy Drugs Have Little to No Effect on Sexual Function for Women in Perimenopause

Two drugs used in hormone therapy for women in perimenopause have been found to have little effect on sexual function. Low-dose oral estradiol and venlafaxine were given to 335 women experiencing hot flashes during an 8-week, randomized, controlled study published in the August issue of Obstetrics & Gynecology. Although  a subtle increase in desire  (estradiol) and decreases in orgasm and pain (venlafaxine) may exist. Sexuality among women in menopause is a largely under-researched and misunderstood area of interest in women’s health. Hopefully this study is the beginning of further inquiry into the subject.