Heart Disease

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Heart Smart Living

Cardiologist, author, and heart health expert Dr. Sarah Samaan offers advice on how to live a heart smart life.

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Early Menopause Doubles Heart Disease Risk

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Like so many biological facts of life, menopause plays out differently for every woman. Menopause happens when the ovaries cease to make estrogen, the “female” hormone, and menstrual cycles stop. For most women, this is a gradual process that may begin several years before the very last menstrual period. For others, estrogen production may come to a rapid halt when the ovaries are removed or when chemotherapy for certain forms of cancer shuts down normal ovarian function. While the average woman reaches menopause at the age of 51, some women experience “the change of life” as early as the 30s or as late as the 60s.

Studies of women who have had their ovaries removed before the time of their natural menopause have found significantly higher rates of heart disease and stroke. Others have suggested that early menopause of any cause may increase cardiovascular risk. Most of these studies have included mainly white women, so there has always been a question as to whether women of other ethnicities may be at the same risk. A new study that comes from the Multiethnic Study of Atherosclerosis (MESA) finds that indeed, all women who go through menopause early appear to be at higher risk.

The study, published in the journal Menopause, tracked an ethnically diverse population of over 2500 women (white, black, Chinese, and Hispanic) for six to eight years. Of those who had undergone menopause (either naturally or surgically) before the age of 46, the risk for cardiovascular disease, including heart disease and stroke, was more than twice that of women who experienced menopause later in life. However, when family history was taken into account, the excess risk appeared much smaller.

While the study did not address what could be done to help lower the risk or extend the time to menopause, there are several important factors that women should take heed of. First, smokers reach menopause an average of two years earlier than non-smokers, so if you want to hold onto your estrogen as long as possible, this is another good reason to quit smoking. Secondly, think twice before having your ovaries removed if they are healthy and you are at low risk for ovarian cancer. In years past, ovaries were often removed at the time of a hysterectomy, even if there was nothing wrong with them. The thinking was that if they were no longer needed for reproduction, why hang on to them? We now know that even after the time of menopause, the little bit of residual estrogen produced by the ovaries can be protective to the heart.

Finally, do everything you can to keep your heart and brain healthy and strong. Estrogen is only part of the equation. A heart smart diet, regular exercise, and maintaining a healthy weight are even more important than estrogen when it comes to heart health. And as an added bonus, choosing a healthy way of life will often help to mitigate those irritating menopausal symptoms.

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Tags: Risk Factors for Heart Disease

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About the Author


MD, FACC

Dr. Samaan is an acclaimed cardiologist, writer, and heart health educator.

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