Most people think of February and think of Valentine’s Day (except those of us in Northeast Ohio who think snow and cold!). In the medical community, we also think of the heart…but the actual organ. Cardiovascular disease is the NUMBER ONE killer of women, causing one out of three deaths each year. Statistics show that women present with cardiovascular disease a decade after men. One study demonstrated that the protective effect of female ovarian sex hormones is lost after menopause. Yet most women still do not want to take hormones after menopause because the fear of cancer! Let me see if I can set the record straight.
Hormone therapy was encouraged and accepted until the Women’s Health Initiative published their data in 2002. The study looked at women around the age of 65, and they were given synthetic oral estrogen and synthetic progestin to see if that helped their cardiovascular outcomes. Instead, they found that there was an increase in blood clots and possibly strokes. Now, more than ten years later, people still think about those findings!
One large study in 2008 showed that if you took estrogen through the skin as a patch or gel, there was NO increased risk of blood clots. So, now we recommend only taking estrogen in the transdermal form. Another study looked at women who did NOT take estrogen after a hysterectomy and calculate that many women died prematurely from acute heart attacks for NOT taking estrogen. Estrogen has been proved in many studies to improve cholesterol, which is a risk factor for cardiovascular disease. In addition, one study in 2012 showed that taking transdermal estrogen and natural progesterone actually decreased the risk of heart attack AND decreased the risk of type 2 Diabetes. So in my opinion, transdermal estrogen and natural progesterone taken at the start of menopause is good for your heart!
Other hormones play into the risk for heart disease. Cortisol, a hormone that increases with stress, has also been linked to a greater prevalence of heart attacks. And it gets worse – chronically high cortisol can lower your testosterone. Low testosterone in women is associated with increased in all cause mortality and cardiovascular events independent if other risk factors.
Even minor hormones, such as Melatonin and Vitamin D, can contribute to heart disease if they are not in the optimal range. Optimal thyroid levels are also beneficial in reducing your risk of heart disease.
After all of these studies, somehow the public perception is still that “hormones will cause cancer!” We’ll save that debate for another day. What we at Forum Health Akron DO know is that estrogen is protective in women against heart disease. It is important to know not only your numbers (blood pressure, cholesterol), but also your hormone levels. Consider taking the Go Red Challenge this year and optimizing your health!