Menopause and Heart Disease

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Does menopause increase my risk for heart disease?

Heart disease, also known as coronary disease, is the leading cause of death for Canadian women. Increased risk for coronary disease is primarily associated with the process of aging, yet there is also a relationship between heart health and a woman's midlife transition through menopause.

Before menopause a woman's heart and blood vessels seem to have some protection due to her hormones. But when a woman experiences menopause, her levels of estrogen decrease significantly, and as a result, her risk for heart disease increases.

A woman has a reduced rate of heart disease before menopause compared with men her own age. After menopause, however, a woman's rate of heart disease increases considerably, until by the age of 65, her risk is equal to that of her male peers.

Will hormone therapy prevent heart disease?

For many years researchers believed that hormone therapy (HT) was beneficial for heart health. Medical practitioners routinely prescribed hormone therapy to women as a preventative measure for heart disease.

However, several new important studies, such as the Women's Health Initiative study, have cast significant doubt on this practice.

Recent research has found conclusively that there is no coronary health benefit for women with a history of heart disease, who take estrogen alone, or estrogen plus a progestin. The studies suggest that there is even the possibility of an increased risk for heart disease for women on hormone therapy.

Research has also found that women without a previous history of heart disease may also face an increased risk for heart disease when taking hormone therapy.

What are the current guidelines for hormone therapy and heart disease?

The Heart and Stroke Foundation of Canada has issued new recommendations as a result of the latest study data:

  • Hormone therapy should not be prescribed to women who already have a history of heart disease.
  • Hormone therapy should not be prescribed solely in order to reduce the risk of developing heart disease.
  • Other non-medicinal measures can be undertaken to reduce the risk of heart disease, such as stopping smoking, becoming more active and reducing blood pressure and cholesterol levels.

The Society of Obstetricians and Gynaecologists of Canada also recommends that HT should not be used for the prevention of heart disease.

Where can I go for more information?