Does death love menopause?

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Publication Date: 
Mon, 2012-12-17

By Laura Wershler

First published by Troy Media Feb. 10, 2012

The Heart and Stroke Foundation of Canada has inaccurately branded menopause as a killer of women.

Last October, the foundation launched the Make Death Wait fundraising campaign. TV spots personify death as a man with a disembodied voice saying he loves women (and men) and is coming to get them. He sounds like a stalker.

Eileen Melnick McCarthy, director of communications for the foundation, wrote in an email that the intent of the campaign is to “wake up Canadians to the threat of heart disease and stroke.” The campaign – urging viewers to “make death wait” by making a donation – has drawn both support and criticism.

Indefensible statement?

The TV ads are creepy, but what was more disturbing was the Death Loves Menopause message in the December issue of Chatelaine magazine. The copy reads: “He loves that menopause makes women more vulnerable to heart disease and stroke.” But is this statement defendable?

Dr. Jerilynn Prior, endocrinologist and scientific director of the Centre for Menstrual Cycle and Ovulation Research says it is myth that estrogen deficiency associated with menopause causes heart disease in women. In an article about women’s risk for cardiovascular disease she explains the assumption: “The reasoning behind this notion goes like this – young women have lots of estrogen and don’t get heart attacks. Older menopausal women are “estrogen deficient” and get heart attacks. Therefore, lack of estrogen causes women’s heart disease. That is like saying that headache is an aspirin-deficiency disease!”

Prior writes that sound research – randomized double-blind placebo-controlled trials – has proved that estrogen treatment does not prevent heart disease, and therefore that “estrogen deficiency” is not a risk factor. Yet the myth persists.     

It may be true that heart disease and stroke is the No. 1 killer of women, but the ad’s assertion that menopause makes women more vulnerable to cardiovascular disease raises the ire of women’s health experts.

Joan Starker, a PhD clinical social worker specializing in midlife, menopause and aging issues, calls it “an appalling and shocking advertisement.” Starker says she and her colleagues have “worked hard to shatter negative conceptualizations of menopause and aging. When I viewed this ad, I was left with only one horrifyingly toxic message – menopause equals death – which is ageist and sexist.”

Barbara Mintzes, epidemiologist and assistant professor at the University of British Columbia, works with Therapeutics Initiative, a UBC-based research group that reviews clinical trial evidence on the effectiveness and safety of drug treatments. It’s within this context that she has looked at the information on heart disease and menopause. She calls the ad “misleading and inaccurate” and says “there is no sudden shift in the rate of heart disease post- versus pre-menopause (or around age 50), as would be expected if menopause was a major risk factor for heart disease. As women age, our risks of heart disease gradually increase, similarly to ageing in men.”

Why then is the Heart and Stroke Foundation telling me otherwise? According to the risk assessment I took on the Make Death Wait website, I have just two of 17 negative risk factors. The first is age: I’m a 58-year-old menopausal woman. The assessment advises that “a woman’s risk of heart disease and stroke starts to increase dramatically after menopause.”

Paula Derry, a PhD health psychologist who critiques and analyzes menstruation research and theory, disagrees. She says, “The idea that women’s risk of heart disease increases after menopause is a common one, yet there is little evidence for any increase in risk, much less that menopause is a key cause of heart disease and death.”

Derry cites a 2011 British Medical Journal paper called Ageing, menopause, and ischaemic heart disease mortality in England, Wales, and the United States that concluded aging rather than menopause was key: “Heart disease mortality in women increased exponentially throughout all ages, with no special step increase at menopausal ages.”

Scare tactics

Derry says, “If I were going to donate money to an organization it would not be to one that tried to scare me with what I understand to be inaccurate facts.”

Last March, the American Heart Association issued the Effectiveness-based Guidelines for the Prevention of Cardiovascular Disease in Women – 2011 Update.  These guidelines present a long list of risk factors such as obesity, poor diet, physical inactivity, high cholesterol, hypertension and diabetes. Menopause is not included as a risk factor.

The Heart and Stroke Foundation of Canada should “wake up” to the truth about heart disease and menopause.