Menopause and Heart Disease: The Real Connection

A few years ago, women everywhere were alarmed when studies seemed to indicate that hormone replacement therapy (HRT for short) for reducing symptoms of menopause, seemed to lead to increased risk of heart disease.

HRT had seemed like a God-send to women suffering from symptoms of menopause. Symptoms like night sweats, insomnia, hot flashes, extreme irritability, and even the inevitable weight gain were treatable with many forms of hormone replacement. Faced with a choice between fatigue from no sleep, embarrassing hot flashes in public and mood swings or an increased risk of heart disease and stroke, many women felt caught in a dilemma. Some women were even angry at the years they had spent taking HRT. Still others were angry at the thought of giving up the hormone replacement therapy that was easing their menopausal symptoms so well.

In addition to easing insomnia, fatigue and hot flashes of menopause, hormone therapy even kept some of the more cosmetic changes at bay. Hormone therapy is known to keep skin supply and hair shiny and thick for much longer.

But not the medical and scientific communities are agreed that taking hormone replacement therapy to relive the worst of the symptoms during active menopause poses no additional risk. Timing matters. If a woman starts hormone therapy within the first 10 years after the onset of menopause and takes it for only four or five years, there is no added risk of heart disease.

Older women, however, are not so fortunate. Those hormones aggravate the artery clogging plaques that develops naturally in age, anyway. Estrogen and progestin seems to encourage the clots that form around the plaques to burst, causing heart attacks.

In general, the concensus seems to be that hormone replacements is safe enough if used to treat the night sweats and hot flashes of menopause for the period of time those symptoms are worst. And that is what the hormone supplements were created to do in the first place.

There is one other possible reason why the study in 2002 indicated that increased use of HRT also increased incidence of heart disease. The latest studies suggest that a difficult menopause might be a sort of blessing in disguise. The most recent results indicate that women who suffer the most from their menopausal symptoms also have more risk factors for heart disease such as high blood pressure, high cholesterol, diabetes and excess weight.

That makes an intense menopause an early warning sign of other health risks. According to a lead author on these recent studies, women with moderate to severe hot flashes should follow up with their doctors to check their risk factors for heart disease. And women currently taking hormone replacement therapy need to see their doctors regularly, too. There is somewhat of a higher risk of both stroke and breast cancer with hormone therapy. Women need to get regular mammograms and blood pressure checks if they are on hormone therapy.

Probably another reason why the saying "Old age isn't for sissies" rings so true.