By Dr. Chauncey Crandall
The role of estrogen in heart health has become somewhat
controversial in recent years. Previously, estrogen was thought to be
protective of the heart in women, because women generally develop heart
disease about 10 years later than men. This coincides with menopause,
when a woman’s estrogen levels decline dramatically. By age 65, a
woman’s risk of heart disease is equal to that of men.
When female estrogen goes down, harmful LDL cholesterol increases
in the bloodstream and “good” HDL cholesterol decreases. This leads to a
buildup of fat in the arteries that increases the risk of heart attack
and stroke.
Based on that evidence, hormone replacement therapy (HRT)
was considered to be standard treatment during menopause as recently as
10 years ago. Besides relieving the outward symptoms of menopause, such
as hot flashes and insomnia, it was thought to keep cholesterol under
control and have a positive effect on blood vessels and the heart.
However, that thinking began to change in the late 1990s, when
additional study results of HRT started coming in. For instance, the Heart and Estrogen-Progestin Replacement Study (HERS)
followed more than 2,700 women with existing heart disease; during the
first year of HRT, women in the study had a 50 percent increase in heart
attack and stroke, according to the Journal of the American Medical
Association.
The Women’s Health Initiative (WHI), a study of 160,000 women,
showed similar results. The part of the study that involved HRT with
estrogen and progesterone was even halted in 2002 because the hormones
were causing an increase in heart attacks, strokes, and blood clots in
the legs and lungs.
In 2004, the estrogen-only HRT study was stopped because it did not
reduce the risk of heart attack, but increased the incidence of stroke
and blood clots, according to a report from The Cleveland Clinic.
There’s no getting around the fact that estrogen levels decline with
age. Each woman should work closely with her personal physician to
determine whether to undertake hormone therapy to bring those levels
back up. Other factors, like a history of blood clots or cancer, must be
considered before increasing these hormones.
For women with premature menopause, hormone therapy is usually
necessary. Women who go into menopause before the age of 40 have a
different set of health risks than women who reach menopause at the
average age of 50. One of those risks is a higher incidence of heart
disease.
Hormone therapy does seem to reduce that risk when started soon
after menopause in younger women. Older women with severe menopausal
symptoms should work with a physician to take the lowest effective dose
only as long as needed.
For both men and women, hormone balance is key. Be aware of
environmental estrogens that might lead to overload in your body.
Besides hormones and pesticides in food, other sources are things that
get into the water supply. Switch to biodegradable laundry detergents.
Always recycle old cell phones, computers, and printers rather than put
them in the trash. That will help control the release of heavy metals
that turn into environmental estrogens.
Source: http://chaunceycrandall.com/2764/women-balance-estrogen-for-heart-health/
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