​ As we celebrate this special month of love, it is important that all women understand the vital relationship our heart shares with our hormones.  Heart disease remains the number one cause of death in both men and women in the United States.  Prior to menopause, women are at a lower risk of heart disease than their similarly aged male counterparts.  However, this advantage decreases after  menopause.  Scientific research has shown that declining levels of estrogen increases a woman's risk of heart disease.  Specifically, when a woman enters menopause, her hormone levels  will decline.  This generally occurs in women between 50-54, however each woman and her experience may be different. Testosterone levels decline first, followed by estrogen and progesterone.
 
Did you know declining Estrogen levels affect your Heart?
Understandably, we tend to associate menopause and declining estrogen levels with hot flashes, decreased bone mineral density, decreased libido, decreased energy levels, and brain fog. However, in addition to these factors, low estrogen levels cause the blood vessels of the heart to harden, thus making the heart work harder and ultimately resulting in elevated blood pressure, changes in our heart rate and heart rhythms. Likewise, our cholesterol levels are affected by menopause - triglycerides and LDL (bad cholesterol) increase, while  HDL (good cholesterol) decrease.  As women approach menopause, our bodies become resistant to the insulin, a hormone that is needed to convert sugars from food into energy. Coincidentally, it is at this time that many women are diagnosed with pre-diabetes and diabetes. These hormonal changes put women at risk for heart disease and stroke. 

One of the more common complaints of many women, in addition to the discomfort of hot flashes, is weight gain, which happens because metabolism slows tremendously. Related to menopause, hormones determine how we store and burn fat and often this weight gain is around our “midriff” area.  This increase in weight places strain on the heart and also may increase the likelihood of heart disease and stroke. 

Testosterone The “me too" Hormone
Testosterone is the hormone that is often overlooked as it relates to its benefits to the aging woman. Importantly, testosterone has a cardio-protective effect on the blood vessels of the heart.  In fact, some studies have linked low testosterone to cardiac risk factors.  By reducing body fat and increasing muscle mass, testosterone helps to reduce heart vessel inflammation.   A study published in the Journal of the American College of Cardiology showed that testosterone supplementation improves insulin resistance and functional capacity in women with congestive heart failure. Some testosterone is converted by the body into estrogen and may not be suited for everyone.  Proper work up and treatment is of vital importance.

The Good News!
Heart Disease is preventable and treatable.  This month's emphasis on love is the perfect time to focus on the most important people in our lives  including ourselves. Women can start by making exercise part or their weekly routine, quit smoking, check blood pressure regularly and eat healthier foods including fruits and vegetables. 
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See your Gynecologist for hormonal testing and treatment.  It’s time to take charge and normalize those hormones!