How Estrogen Protects Against Heart Disease

After menopause, your risk of heart disease increases

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A senior woman using a laptop. Hero Images/Getty Images

Prior to menopause, women produce sufficient amounts of estrogen, which decreases their heart attack risk significantly. After menopause, though, estrogen levels fall, and by age 60 to 65, men and women have approximately the same risk of developing heart disease. This drop in estrogen is detrimental since estrogen can protect you from developing certain types of heart disease. As rates decline and stay low with age, recent data suggests women over the age of 75 may surpass men of the same age when it comes to heart disease risk.

How Estrogen Affects Cholesterol Levels

The majority of estrogen’s protective effects are likely to come from its influence on regulating cholesterol levels. Estrogen acts on the liver to cause an overall reduction in the total amount of cholesterol in the body, increases the amount of good cholesterol (HDL) and decreases the amount of bad cholesterol (LDL).

Over time, bad cholesterol can accumulate as deposits in your blood vessels. This can lead to blockages that interfere with the delivery of blood to your heart.

Decreasing your level of bad cholesterol reduces the likelihood these blockages form. Good cholesterol, on the other hand, is actually an anti-blockage type of cholesterol. Good cholesterol reduces both the amount of bad cholesterol present in the body and makes bad cholesterol less able to accumulate into the types of deposits that cause blockages.

Estrogen and the Immune System

There is some evidence that estrogen also has an effect on the immune system, which further decreases the danger posed by deposits of bad cholesterol.

Once bad cholesterol has deposited in the blood vessels, a complicated immune system reaction causes the affected vessel to become inflamed.

This inflammation leads to further blockage while increasing the risk that a part of the deposit may break off and travel downstream to a narrow area of your vessel.

Here it can lodge and cause a heart attack or stroke.

Preventing Heart Disease

Regardless of your age or estrogen level, you can lower your risk of heart disease through lifestyle adjustments. One of the best things you can do for your heart is to stop smoking. If you smoke, talk to your doctor about quitting, they can give you tips, resources, and medications that can make quitting easier. Also beneficial for your heart health is regular exercise and maintaining a healthy diet. If you want to adopt a healthier lifestyle, but aren't sure where to begin, talk to a nutritionist about your diet and work with a personal trainer to identify which workouts are best for your body and activity level. 

To help lower your risk of heart disease after menopause, your doctor may prescribe an estrogen-based hormone therapy. Estrogen supplementation can lower your risk of heart disease as well as protect against osteoporosis, bone loss that increases with age—especially after menopause. These therapies do come with some risks, so make sure to tell your doctor about your health history as well as your families before starting a new prescription.

Sources:

Derry PS. Update on hormones, menopause, and heart disease: evaluating professional responses to the Women's Health Initiative. Health Care Women Int. 29(7):720-37.

Sare GM, Gray LJ, Bath PM.Association between hormone replacement therapy and subsequent arterial and venous vascular events: a meta-analysis.Eur Heart J. 2008 Jul.

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