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Each year in the United States, about 1.3 million women make the journey through menopause. The side effects that can come with this hormonal transition are numerous and include everything from hot flashes to an increased risk for cardiovascular disease.
Since women are living much longer today than they did just a century ago, the medical world is taking a fresh look at hormone therapy and how it can help promote better health and quality of life as women age.
In fact, at Upper East Side Cardiology, board-certified cardiologist Dr. Satjit Bhusri is a champion of using hormone therapy (HT) to prevent cardiovascular disease in women, and we explore the ins and outs of this treatment below, including timing.
Your hormones and your heart
When you transition through perimenopause and menopause, your levels of reproductive hormones — estrogen and progesterone — drop off quite a bit. Even though this puts an end to your reproductive stage, these hormones also serve other important areas of your health.
For example, there are cardioprotective benefits that come with estrogen, namely encouraging vasodilation, which helps to keep plaque from forming on the walls of your arteries.
Since plaque formation is one of the key precipitators of heart disease, this is one protection you might want to keep in place, which we can accomplish through hormone therapy.
The new science behind hormone therapy
More than two decades ago, a Women's Health Initiative study found that HT might increase risks for certain serious diseases, such as cancer. This study derailed HT for years until new research pointed us in the right direction — HT does far more good than harm for postmenopausal women.
Today, we’ve moved past this flawed study to recognize that women are living longer, and these years are spent without the protective benefits of reproductive hormones, which is where HT comes in.
New research has found that HT significantly reduces the risks for cardiovascular disease in women who start the therapy before the age of 60 and within 10 years of transitioning through menopause.
Timing matters with HT
The new studies on HT emphasize that HT should be started within 10 years of menopause and before the age of 60, and we want to explain why.
As you age, your risks for cardiovascular disease increase, regardless of gender, hormones, etc. So, if you go 10 years without estrogen, your risks have increased, often beyond the point where HT can play catch up. Commencing HT after this point might do more harm than good, but this is an area of research that’s ongoing.
Taking HT for longer
At the same time as researchers have identified an ideal window for starting HT, they have also found that women can take HT for longer than we originally thought. A recent study concluded that, “Continuing HT beyond age 65 years is a reasonable option with appropriate counseling and regular assessment of risks and benefits.”
The takeaway here is that women who are entering perimenopause and menopause should take a fresh look at HT.
If you’d like to explore HT and your heart health further, we invite you to check out this video discussion on menopause and heart health that features our own Dr. Bhusri.
And if you want to explore whether HT can benefit you, we invite you to call our New York City office on the Upper East Side of Manhattan at 212-752-3464. You can also request information online by clicking here.