As data from various studies on hormone replacement therapy for women have been compiled and reviewed, there are recommendations which are emerging. Cardiovascular disease is the principal cause of mortality in postmenopausal women, and whether a woman takes hormone replacement or not may have a huge impact on her risk. Estrogen has the potential of reducing risk on several levels. First, it is a vasodilator, which means it opens up blood vessels, which will decrease blood pressure, and increases blood flow and oxygen to organs. It is also an antioxidant, and protects arteries from plaque formation by blocking oxidation of LDL. It also affects the liver, increasing production of HDL, decreasing LDL levels, and decreasing total cholesterol levels.
Estrogen also helps to “sensitize” insulin receptors. This helps the body respond to insulin, to better balance blood sugar and prevent diabetes. What does this have to do with heart health? Insulin is very damaging to the inner lining of blood vessels. Damage to the lining of blood vessels will stimulate plaque formation.
Estrogen levels start decreasing in perimenopause; and of course, reach very low levels in menopause when ovarian function drops. Benefits in heart protection can be obtained for women if they start estrogen therapy earlier than later, and estrogen is continued long term.
It has been proposed that there appears to be a window of opportunity for women to receive the cardioprotection that hormones may provide if they start therapy within 10 years of menopause. If hormone therapy is delayed beyond that point, there is an increased risk of coronary events associated with hormone therapy, within the first two years of use. This probably results from plaque which may dislodge on increasing vascular flow from dilation of blood vessels.
Concluding thought: If you are interested in hormone therapy, the sooner you can start as your own hormones decrease , the better protection against heart disease