Health Care

Women’s Cardio Health and Hormones: Getting to the Heart of the Matter


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It isn’t always easy or comfortable for women to talk about menopause, even though menopause is a perfectly normal phase of life for all women, usually starting in the 40’s and 50’s.

But when you consider that heart disease is the leading cause of death for women — and menopause can directly impact a woman’s heart health — then it’s vitally important to get past the awkwardness and get the facts.

One of the most important facts is that the hormones estrogen and progesterone play a major role in women’s good heart health. Actually, one of the reasons younger women are felt to be protected from heart disease is because they have circulating levels of both hormones.

“Estrogen relaxes the lining of the blood vessels — helping to keep them flexible. It helps keep the cholesterol levels lower which helps to prevent buildup of plaque inside of your blood vessels,” said Michelle Dew, MD, FACC, Cardiologist, AdventHealth Shawnee Mission.

In addition, progesterone reduces blood pressure and has direct relaxing effects on blood vessels. This direct action can ease symptoms such as hot flashes, night sweats, anxiety and insomnia.

But when menopause occurs, both estrogen and progesterone levels naturally fall — and a woman’s risk of heart disease increases.

Menopause refers to the time when a woman’s ovaries stop producing estrogen. This process doesn’t happen like turning off a light. It can take months or years.

“When there is less estrogen, there will likely be a resultant increase in total cholesterol and a decrease in good cholesterol (HDL). These changes are well known to increase the risk for heart disease,” said Dr. Dew.

Generally, blood pressure also increases after menopause. Changing hormones related to menopause may cause blood pressure to rise. Additionally, an increase in body mass index (BMI) during menopause definitely contributes to higher blood pressure.

“There is often a transition from a “pear-shaped” body — wider hips/thighs with more weight below the waist — to more of an “apple-shape” — wider waist and belly with more weight above the waist — as we age and experience lower estrogen levels. Research has shown us that the “apple-shape” is more strongly linked to risk of heart attacks in women,” said Dr. Dew.

These hormone changes also can make blood pressure more sensitive to salt in the diet. When this happens, blood pressure can go up.

“Even if a woman has normal blood pressure at age 55, she still has an 80 percent chance of developing hypertension in her later years,” said Dr. Dew.

Left untreated, hormone imbalances are more than just annoying mood swings. Not getting your hormones back in balance could lead to other problems like elevated cholesterol, osteoporosis, obesity, lack of sleep — all heart health challenges. Menopause treatment can make a difference.

Some rare, lucky women don’t need treatment for their mild menopause symptoms. For some women, the symptoms simply go away on their own. But for those who do need more help, there are several therapies used to manage symptoms. The most common and effective treatment is hormone replace therapy (HRT).

“HRT is well-known to provide the best relief from menopause symptoms (there are more than a hundred of them!). Keep in mind, menopausal symptoms can affect women for one third or more of our lifetime,” said Dr. Dew.

HRT involves taking estrogen or a combination of estrogen and progesterone during perimenopause (the transitional time before menopause is complete) and menopause.

“When prescribed properly, estrogen is considered more safe than not and can help lower cardiovascular risk,” said Dr. Dew.

The positive influence on multiple organ systems in the female body has been well- documented. These include, but are not limited to, the urinary system, bone health and mental health including anxiety and depression. The decision to start using these hormones should be made only after you and your health care provider discuss your particular risks and benefits.

For more information, visit or call 913-632-9400.

Staying Healthy at Menopause and Beyond

Although hormonal imbalances can require medical intervention, a healthy lifestyle can have a major impact on improving low- level menopause symptoms.

  • Get six to eight hours of sleep each day.
  • Do 30+ minutes of daily vigorous exercise — even walking counts!
  • Have a high-quality diet with enough protein and healthy fats and less sugar.
  • Reduce or manage stress, which can severely affect your immune health.

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