Oestrogen has heart protective qualities, including reducing the levels of ‘bad’ cholesterol in your blood. During the perimenopause, oestrogen levels fluctuate and during the menopause, levels fall. Studies have shown that women who are at a younger age when they are menopausal have a greater risk of developing heart disease as they have longer without their hormones.
Evidence shows that if you start taking HRT during your perimenopause, or within 10 years of your menopause, you have a lower risk of developing heart disease and a lower risk of death from heart disease than those who don’t take HRT. If you have an early menopause or surgical menopause before the age of 40, you are at higher risk of cardiovascular disease, as the longer a woman is without her hormones, the greater her future risk of developing heart disease.
What about Palpitations?
Palpitations are the sensation of a fluttering in your chest, it may also feel as though your heart is racing or missing a beat. It is a common symptom during menopause. Fluctuating levels of Oestrogen can cause palpitations , anxiety symptoms will also affect your heart in this way. Whilst palpitations can feel alarming, in most cases they are usually harmless.
If your palpitations: last for more than a few minutes, you develop chest pain or shortness of breath, or if the palpitations are tending to get worse rather than better it is worth having them checked to rule out other causes
HRT and High Blood Pressure
Blood pressure tends to rise with age – around two thirds of adults over 60 have high blood pressure. The drop in oestrogen that occurs during the menopause doesn’t directly raise your blood pressure, but it is linked to a much higher risk of heart disease and heart attacks.
High blood pressure puts a strain on your heart and blood vessels and increases risk of heart disease, heart attack, stroke and many other diseases.
Hypertension is usually caused by a combination of risk factors. As well as your age, your blood pressure can be raised by your genes (this means hypertension can run in some families), being overweight, not exercising enough, eating a diet which is high in processed food and saturated fat, smoking, drinking excess alcohol.
For most women, it’s perfectly safe to take HRT if you have high blood pressure or you’re taking medicines to lower your blood pressure. Your blood pressure will need to be monitored to keep an eye on your blood pressure and adjust your medicines if needed.
Oestrogen taken as a tablet has the potential to raise blood pressure but taking oestrogen through the skin (trans dermally) as a patch, gel or spray allows your blood vessels to dilate – so it can lower your blood pressure rather than raise it. It also reduces inflammation in the lining of your blood vessels.
While some progestogens could raise blood pressure, the newer type, micronised (body identical) progesterone, appears to have no effect or may even lower blood pressure.
The higher your blood pressure, the greater the risks to future health. In the UK, if your blood pressure consistently raises to 140/90mmHg or over, this would be diagnosed as high.
HRT and Cholesterol
The cholesterol in your blood often rises during menopause and this continues into old age.
High cholesterol can increase with too much fatty food, not exercising enough, being overweight, smoking and drinking alcohol.
Taking body-identical HRT usually lowers cholesterol – oestrogen can decrease LDL (bad) cholesterol and increase ‘good’ HDL cholesterol. By correcting the hormone deficiency and replacing the missing hormones, HRT can contribute to lowering your risk of heart disease in future.
If you already have heart disease you will need individual advice. In general, oestrogen taken through the skin in a patch, gel or spray does not have an increased risk of clot or stroke. If you need to take a progesterone as part of your HRT, micronised progesterone is recommended and this does not increase your risk of clot either. Synthetic oestrogen taken in tablet form can slightly increase the risk of blood clots, deep vein thrombosis and stroke, but the overall risk of stroke in women under 60 is low.
Regards
Amanda
