Hot flashes. Night sweats. Sleep disturbances. Mood swings. Irregular and racing hearts. These are all signs of menopause setting in, the time in a woman's life when her ovaries cease to function signaling the end her fertility years, her menstrual cycle and a drop in naturally produced hormones.
As if the possibility of menopausal symptoms setting in as early as age 40 isn't unsettling enough, check out these disturbing facts: a woman's risk for heart disease automatically increases at age 40, and heart disease is the leading cause of death in women over 40, particularly those in the midst of menopause.
If menopause does not cause heart disease, then why is this such a significant time? Estrogen is a hormone that has a positive effect on the cardiovascular system by keeping the blood vessel walls flexible. The decrease in estrogen as menopause sets in causes negative changes to occur to the blood vessels, no longer protecting them in the same way and through the changes in the walls of these vessels, clots are more apt to form. In addition to these changes, in post-menopausal women, blood pressure begins to go up and LDL cholesterol ("bad") levels rise while HDL ("good") stay the same.
So what's a woman to do? It was once thought that hormone replacement therapy (HRT) not only helped stave off these unwanted symptoms of menopause but also helped to keep more serious health threats such as heart disease, cancer and osteoporosis, at bay. In 2002, however, HRT studies involving these hormones were halted secondary to evidence that women in them showed an increase in risk of heart attack, stroke, breast cancer, and even dementia.
The known increase in heart disease in this subset of women has led to increased screening and a more personalized approach when it comes to treating menopause. According to Kelly Anne Spratt, DO, Penn cardiologist, "Treating a woman for menopause depends on many factors, including how severe and life-altering her symptoms are, her current health status, medical and family history and treatment preferences. Many symptoms can be effectively managed through lifestyle changes and other types of therapies."
One thing is clear, however. HRT should not be used to prevent heart disease. Nor should women with heart disease take it. And, women need to enlist the help of a physician. They can start with their primary care doctor or their gynecologist and discuss with him other ways to decrease blood pressure and LDL cholesterol and prevent heart attack and stroke, such as lifestyle modifications (i.e. switching to a heart-healthy diet and quitting smoking) and keeping blood pressure and cholesterol levels under control with the proper medications.
"I would also strongly suggest that menopausal women who have a family history of heart disease or are showing symptoms of heart disease of or have multiple risk factors for cardiovascular disease should seek the professional medical advice of a cardiologist in addition to their primary care physician," adds Dr. Spratt "A woman's risk for cardiovascular disease – including heart attack and stroke – bone loss and cancer is subject to change as she gets older. That's why it's so important for her see a physician regularly to review her health status."