Women are relatively protected against heart disease, up until the time of menopause, when their heart disease risk increases. Why is this so? It appears that, prior to menopause, the female hormones of estrogen and progesterone are protector hormones, limiting the amount of atherosclerosis, and resulting heart disease a woman has.
Unfortunately, a woman’s risk of heart disease does increase with age to make it the leading cause of disease and death in women who are 40 years of age or older, especially following menopause, when the estrogen and progesterone levels go down.
In fact, about 400,000 women in the US will die from diseases related to heart disease every year. This means that a woman dies of heart disease in the US about once every minute.
The Risk Of Female Heart Disease Rises With Age
Like men, the risk of heart disease rises with age but women tend to get heart disease sometime during their later years after they have reached menopause. During menopause, the woman begins to have a reduction in the ovarian production of estrogen so that, at the time she stops having periods altogether, very little protective estrogen is made by the ovaries and the risk of heart disease rises.
Some common symptoms of menopause include night sweats, mood changes, hot flashes, and vaginal dryness. Natural menopause usually happens between the ages of 45-55 years although women can have surgical menopause if they have their ovaries removed surgically at an earlier age. When this happens, the ovaries are removed along with the uterus and the woman stops having periods and enters early, sudden menopause.
Heart Disease And Menopause
As mentioned, menopause is associated with a reduction in the female hormone, estrogen, and this is believed to be why there is an increased risk of heart disease following menopause.
When menopause occurs, the following changes happen inside the body that increase risk for getting heart disease:
• The level of “good” cholesterol decreases (HDL cholesterol) and the level of “bad” cholesterol rises.
• The blood vessel walls are changed so that blood clots and cholesterol plaques are more likely to happen.
• Fibrinogen levels rise. Fibrinogen is a protein that allows for the clotting of blood. Because heart disease is the result of a blood clot forming in the arteries leading to the heart or brain, the increase in blood clotting seen after menopause increases the risk of having one of these blood clot form, causing a heart attack or stroke.
How To Reduce Your Risk Of Heart Disease
Because there is a lack of the female hormone estrogen after menopause, changes must be made to the lifestyle before reaching menopause in order to keep the risk of heart disease to the lower levels enjoyed prior to menopause.
Some of these lifestyle changes include the following:
• If you are overweight or obese, you should make every attempt to lose weight. If you are of normal weight (with a body mass index of 25 or less), you should try to stay below those levels.
• If you are a smoker, you should stop smoking; if you do not smoke, you should never start to smoke.
• You should eat a diet that is low in saturated fats (found in meats and dairy products) and should avoid trans fats, which are also called partially hydrogenated fats. These are found in processed foods and are used to preserve foods made in factories. Instead, you should eat a diet high in fruits, vegetables, fish, whole grains, lean meats, and legumes (like peas and beans).
• You should engage in moderate physical activity for thirty minutes per day on most days of the week. This can mean walking, running, bicycling, using a treadmill or stair-stepper, or swimming. You should aim for at least 150 or more hours of moderate exercise on a weekly basis.
• You should take care of obvious risk factors for heart disease, including elevated cholesterol levels, hypertension, or diabetes mellitus. Control of these risk factors can help reduce heart disease even if your estrogen levels are low.
What About Hormone Replacement Therapy Or HRT?
In decades past, there was research evidence pointing to the idea that replacing the missing hormones due to menopause in the form of hormone replacement therapy could decrease the risk of menopause. HRT contains estrogen that is known to be protective against heart disease.
Recently, however, studies of hormone replacement therapy in women who have known heart disease have shown no added benefit from receiving these missing hormones and have, in fact, indicated a rise in heart disease among women who chose HRT over not taking any kind of estrogen replacement therapy.
For this reason, it is no longer routinely recommended to give estrogen replacement therapy to postmenopausal women who have low levels of estrogen in their body.
Studies have recently shown that estrogen replacement therapy may be helpful to women who have been in menopause for less than ten years. If you are interested in HRT, seek the advice of your doctor to see if the risks outweigh the benefits of taking this type of therapy.