Woman, Hormones and Heart Health

If you're confused about the pros and cons of hormone therapy, you're not alone. The scientific community has long theorized that hormones taken to ease menopausal symptoms also help prevent cardiovascular disease, the No. 1 killer of women. In 2002, however, women and physicians alike were stunned by results of the national Women's Health Initiative (WHI) study, which warned that hormones could actually increase the risk of heart disease.

Promising New Findings

After further analysis of WHI data, the most recent news is more hopeful. A report published in the Archives of Internal Medicine (Feb. 13, 2006) suggests that the timing of hormone treatment largely determines its potential health risks or benefits. Because the younger women in the study (ages 50 to 59) had significantly fewer heart-related problems, hormones may indeed prove heart-protective if used early in menopause - before hardening of the arteries, or atherosclerosis, has a chance to develop.

On average, WHI participants were age 63 - far older than 51, the average age of women at the onset of menopause. An older woman who has been without estrogen for many years is more likely to naturally develop atherosclerosis; at that point estrogen therapy, because of its tendency to cause clotting, may do the heart more harm than good.

Clearly, further investigation is needed. For now, researchers agree there are a lot of data to suggest that estrogen is "good early" for preventing heart disease but ineffective or even harmful if administered once atherosclerosis is established.

A Personal Decision

In light of this ongoing medical debate, women are understandably concerned about the safety of hormones.

There are ways to decrease your risk significantly. However, like all medical therapies, menopausal hormone treatment may not be appropriate for all patients. Along with declining hormones, you must have symptoms that are affecting your quality of life. Next, talk with your doctor, who will take into account your age, current health and family health history in determining your specific risks and benefits in using hormones, as well as the potential impact on your cardiovascular health.

If you choose to receive hormone therapy, use bioidentical hormones that duplicate a woman's naturally occurring hormones. While hormone therapy can be both safe and effective, it is not a by-the-numbers kind of treatment. Each woman's case should be evaluated individually.

By Susan Kaib, MD, FAAFP
Medical Director
Kronos Optimal Health Company