Dear Doctor: After Menopause, Am I at Increased Risk for Heart Disease? Why?

Menopause occurs when a woman’s monthly cycle comes to an end and she is no longer able to reproduce.  As we get older, we all have increased risk for heart disease, but this risk is more evident in women who have gone through menopause.  Many doctors and scientists believe that pre-menopausal women who are able to produce estrogen have a protective effect against heart disease; this is partly due to the ability of estrogen to lower LDL (bad cholesterol) and raise HDL (good cholesterol).  After menopause, estrogen levels significantly decrease and the risk of coronary heart disease in a woman becomes equivalent with a man’s risk.

Should I take estrogen replacement?

Several studies have taken a closer look to determine whether post-menopausal women benefit from estrogen replacement therapy in order to prevent cardiovascular disease.  Two notable research studies were the Heart and Estrogen/Progestin Replacement study (HERS) and the Women’s Health Initiative Estrogen Plus Progestin Study (WHI).  Both studies showed no benefit from hormone replacement regarding cardiovascular risk and rather revealed increased harm.  The harmful side effects included increased risk of coronary heart disease, stroke, breast cancer and pulmonary embolism (blood clot in the lung).  As a result of these findings from the HERS and WHI studies, hormone therapy is no longer recommended to prevent coronary heart disease in women, and doctors are guided to treat symptoms of menopause with the lowest dose of hormones for the shortest amount of time.

How do I lower my risk for heart disease?

Following a healthy lifestyle and minimizing the risk factors associated with coronary heart disease will help to significantly lower your risk over time.  This includes good nutrition, regular exercise, smoking cessation, normal blood pressure measurements, and low cholesterol levels.  It is important to meet with a doctor regularly for a thorough assessment and to talk about your personal risks.

Dr. Jean Ekwenibe is a board certified Cardiologist with the McGovern Medical School at Houston, and she is currently available for new patient consultations at UT Physicians at Cinco Ranch located at 23923 Cinco Ranch Blvd., Katy, TX 77494.  To schedule an appointment, please call 713-486-5300.