Heart Health and Hormones

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February is Heart Health Awareness Month and so like many others, I’m here to talk about the importance of heart health but perhaps with a slight twist. 

When thinking about cardiovascular disease, general bias tends to go towards it being a health issue that mostly impacts men. In actuality heart disease is also the number one cause of death for women, impacting 1 out of every 3. This means not only do we need to be taking it seriously but we also need to be looking for it in the first place especially since it often manifests differently in women compared to men. Many women don’t even have the typical symptoms of chest pain. Instead, they might experience persistent nausea, indigestion, or back pain as the only clues to an impending heart attack!

Commonly known risk factors for heart disease include age (hint, menopause!), elevated blood pressure, diabetes, lack of exercise, certain food choices (think high amounts of processed foods, sugar, and simple carbs), smoking, weight gain, and genetics. But did you know that stress, anxiety, depression as well as insomnia, and sleep apnea also increase your risk? And hormonal changes during peri-menopause and menopause can have a distinctly negative impact on many of these risk factors. 

Estrogen does A LOT to help keep our heart healthy including decreasing LDL (the type of cholesterol that causes damage), helping dilate small arteries, and increasing HDL (the protective form of cholesterol) which equals reducing the overall risk of heart disease. 

But during peri-menopause and menopause estrogen decreases significantly which in turn equals no longer having the protective effects against heart disease. Blood pressure may increase due to decreased elasticity in blood vessels as well as decreased dilation of the same vessels, both at least partially due to the drop in estrogen. Often total cholesterol and LDL increase heading into menopause and post-menopause. 

Progesterone (produced during ovulation) also declines in peri-menopause and stops in menopause. This particular hormone has a calming and mild sedative effect. This drop often leads to an increase in anxiety, irritability, and disrupted sleep. Remember the risk factors above of anxiety and poor sleep!

A weight increase of 10-15 pounds is also common in menopause as metabolism slows. When related to estrogen decline, this often triggers more weight gain in the middle (think apple vs. pear shape) which is yet another risk factor of heart disease. 

It can be disconcerting, frustrating, and downright scary to acknowledge all of the challenges menopause can bring especially in terms of heart health but there’s a lot that can be done to not only decrease risk factors but feel amazing doing so! 

Start with understanding your risk factors. This hopefully includes detailed cardiovascular labs beyond the standard lipid panel. And consider having hormone levels evaluated so you know where you’re at (especially if you’re peri-menopausal). Next take an honest look at the quality of your food choices, your daily movement, and stress management so you can start working on small changes now that will provide big positive changes in the future. 

For some women, hormone replacement therapy might be a great choice but it’s not the right fit for everyone. There are herbs and nutrients that can help not only improve symptoms but also improve individual risk factors. And of course, there’s always a time and place for medication, hopefully in combination with all of the above. 

This only scratches the surface of a complicated but very important topic. I’m a firm believer that knowledge is power and I hope this helps empower you to learn more and take control of your heart health.

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