Estrogen may protect some women from heart disease

The Society of Obstetricians and Gynecologists of Canada recently reported that approximately four million Canadian women have reached menopause. By 2026, it is estimated that women over the age of 50 will make up 22 per cent of the Canadian population. Statistics presented by the North American Menopause Society tells a similar story for women living in the United States.

While many of these women seek information and relief from the symptoms of menopause, research into the benefits and risks of hormone replacement therapy has been at best confusing, if not at times, outright discouraging.

Finally, however, there might be good news. Researchers have re-analyzed data from the Women’s Health Initiative (WHI) and found that taking estrogen may be beneficial in preventing heart disease – but only if you are in your 50s and if you begin treatment soon after menopause.

The original WHI study of women aged 50 and older concluded that various combinations of hormone replacement therapy not only failed to protect post-menopausal women from cardiovascular disease, but in some cases, had the opposite effect. When analyzing the benefits estrogen taken alone, the study halted one year ahead of schedule because findings suggested the hormone raised a woman’s risk of stroke.

And yet another study suggested that hormone replacement therapy may increase the risk of breast cancer for some women.

But this latest analysis points to significant benefits for estrogen to women of one age group.

“Overall, the findings are that women who were 50 to 59 did show signs of a reduced risk for heart disease,” said Dr. JoAnn Manson, head of preventative medicine at Brigham and Women’s Hospital and a study co-author. “The findings suggest that there may be differences in the heart outcomes with estrogen therapy depending on the age and time since menopause.”

These new findings can be summarized as follows:

Women in their 50s who were given estrogen alone had a 45 per cent reduced risk for clogged arteries that require coronary bypass surgery or angioplasty

Women on estrogen had a 37 per cent lower risk for heart attacks

For heart attacks, bypass and angioplasty combined, women who were given estrogen had a 35 per cent drop in risk

“In contrast, looking at older age groups… there was no sign of a reduced risk of heart attack or coronary bypass surgery or angioplasty of any of the heart disease endpoints in those older age groups,” Manson said in a teleconference from Boston.

The Society of Obstetricians and Gynecologists of Canada recently updated its position on hormone replacement therapy, saying that women with moderate to severe symptoms of menopause could be prescribed the lowest effective dose for the appropriate duration.

Menopausal symptoms typically include hot flashes, night sweats, and mood swings.