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How estrogen helps women to keep heart problems at bay

How estrogen helps women to keep heart problems at bay

The hormone promotes good cholesterol and insulin sensitivity, thereby reducing heart attack risk

The estrogen hormone promotes good cholesterol and insulin sensitivity, which helps reduce heart attack risk.

Cardiovascular diseases are the leading causes of death around the world but women in their premenopausal age do enjoy some benefits and possibly escape heart attacks, thanks to their sex hormone, estrogen.

Naturally produced estrogen protects women against atherosclerotic cardiovascular problems. Speaking to Happiest Health, Dr Leslie Cho, Director of Women’s Cardiovascular Center, Cleveland Clinic, Ohio, says, “Natural occurring estrogen is cardioprotective because it makes sure that blood is very less likely to clot. It is a vasodilator. Body-producing estrogen creates better cholesterol, and you are more likely to make more good cholesterol, rather than bad cholesterol. It also promotes insulin sensitivity.” 

How estrogen protects against heart diseases

A lot is yet to be discovered about the benefits of estrogen for the heart. Its known effects so far are as follows:

  • It increases HDL or good cholesterol and decreases LDL or bad cholesterol.
  • It improves blood flow.
  • It promotes blood clot formation.  
  • It prevents free radicals, which can damage the arteries and other tissues. It is linked to ischemia, heart failure and hypertension.

A 2020 study, ‘The Role of estrogen Receptors in Cardiovascular Disease’ published in the International Journal of Molecular Sciences by Laila Aryan, David Younessi, et.Al, states that estrogen receptors reduce the size of the localised area of dead tissue due to failure of blood supply (infarct), decrease reactive oxygen species (ROS), which can cause inflammation, and reduces cardiac muscle cell death.

Dr Premalatha Balachandran, Consultant – Obstetrician & Gynaecologist, Motherhood Hospitals, Chennai, says these hormones are primarily produced by a woman’s ovaries, but they are also produced in modest quantities by the adrenal glands and fat cells. “For premenopausal women, estrogen levels should range from 30 to 400 pg/mL and for postmenopausal women, 0 to 30 pg/mL,” she says.

Can low estrogen cause heart issues?

Dr Balachandran adds estrogen levels can drop in women who go through early menopause and as it drops during the perimenopausal years, there is also an increase in cardiovascular risk factors like high cholesterol and hypertension.

She says, “For instance, higher insulin resistance, a risk factor for diabetes, has been associated with decreased estrogen levels. And diabetes is another risk factor for heart disease and stroke. estrogen also has an impact on how your body distributes fat. During menopause, declining estrogen frequently causes weight gain and an increase in visceral fat, which leads to additional stress on the heart. As a result, it also has additional, more indirect effects on the health of your heart.”

Lack of estrogen and heart disease

Usha Ravindran, a 57-year-old homemaker in Kerala, says she had her menopause at the age of 53 and she developed a heart problem recently at the age of 57 years. “I noticed breathlessness and suffocation while walking for more than 30 minutes, especially after eating,” she says.

When she went for a check-up after she developed a fever during the covid-19 pandemic, the doctor recommended her to consult a cardiologist. “I then did an angiogram which detected four blocks in the arteries. I underwent open heart surgery in Mumbai in April this year,” she says.

Though naturally secreted estrogen is considered a cardiac protector for women, the same could not be said for hormonal replacement therapy-induced estrogen medication and other female hormones. This was earlier a standard treatment for menopausal symptoms like hot flashes, night sweats, and insomnia but is now associated with a higher risk for heart attacks.

Low estrogen symptoms

  • Dry skin
  • Tender breasts
  • Brittle or weak bones
  • Having trouble concentrating, depression and anxiety
  • Dryness or atrophy of the vagina
  • Sweating at night and hot flashes 
  • Irregular or no menstruation (amenorrhea)
  • Weight gain, especially around the stomach
  • Headaches before or during your periods
  • Decreased sex desire and uncomfortable sex (dyspareunia)
  • Insomnia

How to increase estrogen?

“Estrogen levels cannot be improved. You need to try to modify the risk factors by controlling your blood pressure, by exercising and eating better,” says Dr Cho, adding that the average age for first heart attack among women is 60 and 70 years, a decade later than men but unfortunately, there is a rise of heart attacks among young women. “Heart attack in younger women, even before menopause, is increasing in the US due to diabetes, obesity, smoking and bad lifestyle choices,” she adds.

Dr Balachandran says a varied diet can provide the body with the nutrients it needs for estrogen metabolism. “You can start including items like cruciferous vegetables, nuts, and whole grains. Apart from this, having a healthy weight, managing stress and getting enough sleep are the ways to keep your hormones under check,” she adds.

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