Review on January 19, 2010
Women who are in the throes of menopause, or who have finished menopause are often prescribed hormones such as estrogen to replace the hormones that the body has lost during the menopause process. It is not yet fully known what effects these artificial hormones have on the body. Researchers are concerned in particular about what effect hormones have on cardiovascular disease and coronary heart disease. Although women report being most concerned about developing breast cancer, they are actually three times more likely to develop coronary heart disease at some point in their life. Coronary heart disease is the leading cause of death for women who are in the throes of menopause or those who have finished menopause. Read further to find out the effect that hormones play on cardiovascular and coronary heart disease.
A Wilson et al. 1985 observational study investigated the effect that hormone use has on mortality rates from cardiovascular disease on women who are post menopause and between the ages of 50 to 80 years old. Women who used hormones had a more than fifty percent higher likelihood of death due to cardiovascular disease and were two times as likely to suffer a stroke than women who did not use hormones. The effect that hormone use has on post-menopause women was even more obvious in women who smoke. The study deduced that "the potential drawbacks" of postmenopause hormone therapy "should be considered carefully before recommending its widespread use. However, few paid attention to this finding about hormones and menopause because it contradicted most other studies which proposed benefit rather than harm from hormone use.
The 2002 Framingham Study increases knowledge about the relationship between hormones, menopause and cardiovascular disease. Among other things, its data suggest that women suffering through menopause are at a higher risk for cardiovascular disease compared with premenopause women of the same age. The study also puts forward that there is no variation in the danger for cardiovascular heart disease between women who have had natural menopause and surgical menopause. This latter result in particular suggests that something more than the absence of the hormone estrogen is at work in the relationship between menopause and cardiovascular heart disease. It also concluded that women who used hormones after menopause had two times the risk of dying from cardiovascular heart disease than women who did not take these hormones, confirming the results of the 1985 study.
These studies certainly challenge earlier beliefs that hormones are beneficial in preventing cardiovascular disease. More investigations need to be undertaken, especially so that results are not thrown into doubt by attacks on methodology. The authors recommend that more studies be done to explore the link between hormones, menopause and cardiovascular disease. In particular, the authors recommend that a study be done so that they have better insight on why premenopause women have better protection against coronary heart disease than postmenopause women.
- JAMA - The Journal of the American Medical Association Arch Intern Med. 2004;164:479-481.