Approximately 290,000 women die each year in the U.S. from cardiovascular disease. This makes cardiovascular disease the leading killer of women. What most don’t realize is that low estrogen could play a role in your risk for cardiovascular diseases. Women have a higher risk of cardiovascular disease during and after menopause, which may be due to declining estrogen levels in the body.
Estrogen plays many important roles in the body. Low estrogen during menopause can lead to symptoms that many of us know about. For example, hot flashes, mood changes, and vaginal dryness. However, declining estrogen levels can also cause other effects on your health. Some of these don’t even have symptoms like high cholesterol and high blood pressure.
Estrogen can help regulate cholesterol levels, which is an important part of heart health. Cholesterol is a type of fat found in your blood. There are good and bad types of cholesterol. However, when people say “high cholesterol,” most of them mean high bad cholesterol, which can affect your risk for cardiovascular disease. LDL cholesterol, commonly known as bad cholesterol, can start to collect and form deposits in your blood vessels, which affects how well your heart can pump blood and may increase the risk for blockages and overworking your heart. HDL cholesterol, a.k.a. good cholesterol, actually helps reduce bad cholesterol levels and makes it harder for LDL cholesterol to form deposits in your blood vessels.
Estrogen acts on the liver to help reduce bad cholesterol and increase good cholesterol in your blood. Therefore, low estrogen levels can lead to high cholesterol. This can put additional stress on your heart and increase your risk for heart attack and death from heart disease. Cholesterol level screenings are important at any age, but especially after menopause when you likely have low estrogen levels. Estrogen replacement therapy may help reduce LDL cholesterol levels and help increase HDL levels for postmenopausal women.
Also, low estrogen can increase your inflammatory response to cholesterol deposits in your blood vessels. This inflammation can constrict blood flow even further and increase the risk for blockages and undue stress on your heart. Low estrogen levels may also cause your heart and blood vessels to become stiffer and less elastic. This can increase your blood pressure, which can damage your blood vessels and increase your risk for stroke, heart disease, and heart failure.
Another common symptom that women experience during menopause due to low estrogen levels are heart palpitations. Lower estrogen levels can overstimulate the heart and cause arrhythmias. For most menopausal women, this is an increase in heart rate. These palpitations can be a sign of atrial fibrillation (AFib), which is irregular and rapid heartbeat due to the upper chambers of your heart beating out of rhythm with the lower chambers. AFib can increase your risk for heart complications like strokes, heart failure, and blood clots.
Low estrogen can also work more insidiously to affect your heart health. Hormone changes can increase your risk for conditions that also increase your risk for cardiovascular risk. For example, low estrogen levels have been linked to increased insulin resistance. Insulin resistance is a risk factor for developing diabetes. Diabetes is another risk factor for heart disease and stroke.
Additionally, estrogen affects how your body distributes fat. Declining estrogen often leads to weight gain and increased visceral fat during menopause. This affects your health in many ways, one of which is putting extra stress on your heart. Therefore, estrogen also has other, more indirect impacts on your heart health. However, estrogen replacement therapy may help reduce these risks and help relieve menopause symptoms.
Many researchers believe that estrogen plays a cardioprotective role in our bodies, which is why premenopausal women have less risk of developing cardiovascular disease compared to men. Some studies suggest that starting estrogen replacement therapy may help reduce your cardiovascular risks. For example, one study followed women who started estrogen replacement therapy in their 50s after having a hysterectomy. That study showed that they had a reduced risk for cardiovascular death. Researchers looked at data from 10,000 women and found that the group who used estrogen replacement therapy after their hysterectomy had 12 fewer heart attacks and 13 fewer deaths over approximately 11 years.
Another study showed that women’s hormone care may also help reduce levels of atherosclerosis, which is plaque buildup in heart arteries. This plaque buildup increases the risk for heart attack, stroke, and other cardiovascular conditions. However, the group of women who used hormone therapy reduced their risk for plaque in their arteries. For example, the hormone therapy group was 20% more likely to have a coronary calcium score of zero, which is the lowest possible score for the test that indicates atherosclerosis. Additionally, women using hormones were 36% less likely to have a score higher than 399, which indicates plaque buildup in the arteries and also a high risk for heart attacks. Therefore, estrogen replacement therapy may help reduce cardiovascular risks during menopause.
There are many symptoms of heart issues that women with low estrogen shouldn’t ignore. If you notice these signs, it’s important to schedule a checkup to help with early detection:
At HerKare, we provide advanced, compassionate healthcare for women. Our goal is to help you improve your quality of life. Whether you’re suffering from low energy levels, hot flashes, or just need a plan for overall wellness, our providers are here for you. To celebrate National Cholesterol Education month, schedule an appointment to learn more about your cholesterol levels, heart health, and learn strategies to help improve your health.