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Menopause and heart disease: Are they connected?

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Because of less estrogen from menopausal changes, cholesterol may build, which increases risk of heart disease.

Heart disease is the leading cause in female deaths. History tells us heart disease risk increases after menopause.

Do menopausal changes cause heart disease?

“The most significant change a woman goes through during menopause is decreasing estrogen levels,” said Dr. Joseph Welter, a Marshfield Clinic OB-GYN physician.

The U.S. Department of Health & Human Services describes the relationship between estrogen level and heart disease in this way, “Estrogen helps keep blood vessels relaxed and open and helps the body maintain a healthy balance of good and bad cholesterol.”

Because of less estrogen from menopausal changes, cholesterol may build, which increases risk of heart disease.

Causation isn’t clear, though age is a definite risk

“Really, the relationship between menopause and heart disease may be that each occurs as a woman ages, rather than menopause itself causing heart disease. Increasing age is a known risk factor for heart disease, and this alone can be an issue in heart health in postmenopausal women,” Welter said.

Other heart disease risk factors include:

  • Smoking
  • High cholesterol
  • High blood pressure
  • Family history of heart disease under age 55
  • Diabetes
  • Overweight
  • Other medical conditions

Hormone replacement therapy use has changed

“In the 1980s, it was common for a provider to prescribe estrogen to help reduce risk of heart disease in menopausal women,” Welter said. “Studies since then have called into question whether menopausal hormone therapy benefits heart health. In some women, it appears that it is beneficial, but in others, it can have negative effects, and it can depend on the type of hormone therapy, the age it is begun, the duration of use and underlying medical issues.”

To be clear, hormone replacement therapy is safe to treat menopausal symptoms in many women, Welter added. Today it is recommended that hormone therapy be used for no longer than three to five years, though that depends on individual situations.

Your provider can help you identify the best treatment for your menopausal symptoms and heart disease risk factors or history.

Staying healthy after menopause

You can prevent heart disease following menopause as the years pass. Try to stay active, consume a healthy diet and keep your body and mind healthy, in general,” Welter said.

Quit smoking, maintain a healthy weight or lose weight and take the medications that help you manage cholesterol, blood pressure or diabetes.

“Talk to your provider. We can help you through the changes and questions,” Welter said.

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