Menopause and hormonal therapy

August 3, 2011

Menopause is associated with a severe decline in estrogen levels that may worsen cardiac risk factors. Premenopausal women who had bilateral resection of their ovaries and did not receive estrogen therapy had twice the risk of myocardial infarction than those who took estrogen. Although menopausal hormone therapy was previously considered cardioprotective, a recently completed trial, the Heart and Estrogen/progestin Replacement Study (HERS I and II), showed no cardiovascular benefit in postmenopausal women with documented Coronary artery disease. Risks included a twoto fourfold increased incidence of venous thromboembolism (vein blood clot) and more than 50% increase in the need for gallbladder surgery. Another major trial, the Women’s Health Initiative (WHI) involving predominantly healthy menopausal women, had the estrogen/progestin component of the study stopped prematurely because of increased incidence of invasive breast cancer in hormone-treated women and an unfavorable global risk score. Therefore, current guidelines do not recommend hormone treatment for primary or secondary prevention of Coronary artery disease in postmenopausal women.

SEE ALSO: Acute myocardial infarction, Cholesterol, Coronary risk factors, Diabetes, Hormone replacement therapy, Hypertension, Oral contraception, Smoking, Stroke, Systemic lupus erythematosus, Venous thromboembolism

Category: Cardiovascular Disease