Hormones can protect the heart in numerous ways, yet many are still confused about whether they are safe or not. Well, guess what? Many healthcare providers are still confused. Today I’m going to take a stab at demystifying this for you.

Estrogen

Estrogen’s role in cardiovascular health is complex- whether young, premenopausal, or postmenopausal! What we know is that natural estrogen (produced by your ovaries)

• helps tissues throughout the body stay supple and flexible, including blood vessels, increasing blood flow
• helps keep blood pressure low
• helps keep blood triglycerides low, increases HDL cholesterol (the helpful kind), and lowers LDL cholesterol levels
• promotes blood clotting
• absorbs free radicals, particles that cause damage

Why are women and providers so confused if estrogen has so many benefits? In part, it’s because of the Women’s Health Imitative (WHI) study released in 2002. With over 160,000 postmenopausal women ages 50-79 participating all over the United States, this study is still one of the largest prevention studies for women. However, the study came to an abrupt halt when it was discovered that women taking the hormone cocktail used in this study had a greater risk of breast cancer, heart disease, strokes, and blood clots. That was BIG news!!! Do you remember it?

Here’s what the news media did not share with most women, and even many providers still do not understand. The hormone cocktail included Premarin (derived from Pregnant Mare Urine), which does NOT act like natural estrogen made in our ovaries or bioidentical hormones (BHRT). Additionally, the cocktail contained Progestins – Synthetic Progesterone – that has clearly been shown in other studies, too, to increase breast cancer risk significantly.

The Heat and Estrogen/ Progestin Replacement Study (HERS), the Estrogen Replacement and Atherosclerosis (ERA) Study, and the WHI mentioned above confirmed that estrogen replacement therapy did not decrease heart disease in women who already have heart disease. Keep in mind, again, these studies are not using Bioidentical hormone therapy. (BHRT). Regardless of synthetic or BHRT, the timing of Estrogen therapy is key in reducing the risk of heart disease, as I describe below.

More on Progesterone

During Perimenopause, progesterone levels can plummet. This not only sets a woman up for a greater risk of breast cancer, but the estrogen dominance caused by the progesterone plunge can also create insidious unrelenting weight gain (especially around the middle) and depression too. Both are known risk factors for heart disease. However, Progesterone deficiency can also trigger narrowing of the arteries (atherosclerotic plaque build-up) and chest pain.

Testosterone

Let’s not forget testosterone. It blows me away that doctors are still not offering testosterone to women!! I was trained 20 years ago that testosterone was critical for us to consider when balancing women’s hormones. Testosterone increases energy, increases sex drive, improves cognition, and improves athletic performance and muscle mass. However, high testosterone has been shown to increase blood pressure, rate of heart attack, and stroke and can also lower healthy (HDL) cholesterol levels. Thus, testosterone also needs to be balanced!!

Bioidentical Hormone therapy

Hormones are essential to our health, our vitality, and our longevity!! As I do, the experts that study functional medicine clearly encourage women to remember that Bioidentical hormone therapy (BHRT) is akin to needing glasses as we age. We are NOT hesitant to get a pair of reading glasses as we age. We are not hesitant to get a new prescription for our glasses as our vision changes. Many are not hesitant to even get Lasik surgery when their vision starts to decline. Yet, many will hold off receiving hormone replacement therapy. The confusion listed at the top of the article has certainly contributed to the fear of hormone therapy for many women. I hope that gaining a bit more understanding has demystified this for you! Personally, BHRT has changed my life, and I will be on them until I die.

Yes, there are still recommendations by western medicine to take “the lowest possible dose for the shortest duration of time,” yet now more and more providers are beginning to see the light as the pioneers in functional medicine continue to shine it, and hundreds of thousands of women have regained their vitality using BHRT.  

Just this week, in Medscape, Dr. Morris Notelovitz, a consultant in adult women’s medicine, was interviewed about the WHI and the implications of Premarin and Progestins (Synthetic progesterone). His big take-home message was that women should receive Bio individualized care when it comes to hormone therapy, to reduce risk and improve their quality of life. He said, “early hormone therapy will also reduce her risk of cardiovascular disease, osteoporosis and possibly cognitive functioning!”

Who doesn‘t want that!!

In Summary

Hormones are essential for vitality, yet they must be natural and balanced. The timing of when you start hormone therapy is important to enhance cardiovascular prevention. If you are premenopausal, the most important hormone balancing efforts you can make is to do all you can to avoid Estrogen Dominance or too many toxic endocrine disrupters/xenoestrogens/foreign estrogens from wreaking havoc with your hormone balance. Here’s to your healthy hormone balance AND healthy heart!!