Estrogen and heart health

Why postmenopausal women have an increased risk of cardiovascular disease.

Men and women have different risk factors for cardiovascular disease in general and one of the key differences is the hormonal profile. The hormone estrogen plays a protective role in the prevention of cardiovascular disease.

  • Estrogen assists in keeping levels of LDL cholesterol low and increases HDL cholesterol, which is beneficial for a cholesterol profile.
  • Estrogen protects blood vessels and tissues against oxidative damage.
  • Estrogen also relaxes the smooth muscle of blood vessels, allowing adequate blood flow to the heart and brain.

As women go through menopause, the ovaries stop producing estrogen and the amount of estrogen in the body declines. This drop is estrogen is associated with the classic menopause symptoms such as hot flashes, night sweats, mood changes, and vaginal dryness. However, this decline in estrogen also increases the risk for a cardiac event such as heart attack and stroke.

We see in the graph below; men and woman have very similar lifetime risk of cardiovascular disease. However, there is about a 10-year lag in the timing for women to be diagnosed with cardiovascular disease. There is a similar trend for heart attack risk. Women who go through the menopause transition earlier in life (in their 40’s) have increased cardiovascular risk. These differences between men and women can be partially attributed to the protective effect that estrogen has on cardiovascular health.

Although estrogen seems to have an overall protective effect on the cardiovascular system, the research in this area is still evolving. The age in which a women receives estrogen therapy matters as well as their individualized risk factors for heart disease and cancer.

Although more research is needed regarding estrogen and cardiovascular risk, we know that around the time of menopause and shortly after, women’s cardiovascular increases substantially. Therefore, it is important to have your cholesterol, blood pressure and other metabolic markers such as glucose and insulin levels assessed regularly.

Looking for an individualized approach to tackle your cardiometabolic health concerns or to optimize health as you age? Let’s chat.

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