How Early Menopause is Linked to a Higher Risk of Heart Disease
March 20, 2019
Menopause is the permanent end of menstruation, and while it does not cause cardiovascular diseases, certain risk factors increase around the time of menopause, because of body changes such as:
- A rise in blood pressure
- An increase in LDL or “bad” cholesterol
- A decrease in HDL or “good” cholesterol
- An increase in triglycerides
- A change in body fat distribution, with fat accumulation around the waist
An unhealthy diet, smoking or other detrimental habits begun earlier in life also can affect a woman’s risk for cardiovascular disease after menopause, says Ewa Gross, MD, PhD, Director of UH Women’s Cardiovascular Center.
When Menopause Happens at a Younger Age
The typical age of menopause is 51 years, Dr. Gross says, but some women go through it at a younger age either naturally or for medical reasons. For example, pre-menopausal removal of the ovaries and some cancer treatments can prompt a younger patient to go through menopause.
“It is known that women with earlier menopause have a higher risk of cardiovascular disease than women who go through it later,” Dr. Gross says.
In fact, each additional year that a woman is not menopausal decreases her risk of cardiovascular disease by 2 percent, Dr. Gross says.
“Women who experience premature menopause, meaning before age 40, or early menopause, between the ages of 40 and 45, are at increased risk for cardiovascular disease, overall mortality, neurological and psychological disease and osteoporosis,” she says.
Can Estrogen Help?
Estrogen treatment can help with some of the adverse effects of early and premature menopause, Dr. Gross says.
“The good news is that in this group of patients cardiovascular disease seems to be mitigated by estrogen,” she says.
However, hormone replacement is not for everyone.
Estrogen replacement should not be taken to protect against cardiovascular disease in women who have gone through menopause at the more typical time. For them, therapy can increase the risk for blood clots and stroke, Dr. Gross says.
“There are a lot of discussions around hormone replacement,” Dr. Gross says. “For most women, the risk is probably higher than the benefit. And for some cancer patients, estrogen treatment will be contraindicated because of their disease.”
There are some women with severe menopausal symptoms who may be candidates for short-term hormone replacement therapy. These are women with less than 10 years since menopause and who are at low baseline cardiovascular risk.
It takes a team approach with medical specialists often involved to guide the patient to the best outcome, Dr. Gross says. “The patient needs to be involved in the discussion so she knows what type of risk she is going to take.”
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