Shashi Agarwal MD asked:
“I have my hormones balanced. Most doctors are giving women synthetic hormones, which just eliminate the symptoms, but it's doing nothing to actually replace the hormones you have lost. Without our hormones we die.” Actress Suzanne Somers
Heart disease is the number one killer of both men and women in American and in most parts of the world. Female hormone replacement therapy (HRT) has been used in the recent past for reducing the risk of heart attacks and cutting down the risk of death in women with established heart disease. However, new data provides compelling evidence that HRT may actually make heart disease worse in women. On the other hand, since men suffer from earlier heart disease than women, it has been postulated that the male hormone, testosterone may increase the risk of heart disease. As a result, andropause, the male equivalent of menopause, has not been treated with male hormone replacement therapy, for heart disease prevention. Recent studies suggest that male hormone supplementation may be heart protective.
Female Hormones
Postmenopausal women have a higher risk of developing heart disease. Since menopause is associated with a decrease in the female hormones, it was postulated that HRT should help prevent heart disease. This logic was further supported by a study published in the August 28, 1997 issue of the New England Journal of Medicine, showing that estrogen increased the good HDL cholesterol comparably to the cholesterol lowering statin, simvastatin, and reduced both the bad LDL-cholesterol and Lp(a), another lipoprotein which increases cardiac risk. Research data also showed that in low doses, estrogen inhibited platelet aggregation and reduced PAI-1, plasminogen activator inhibitor, and thereby helped dissolve small blood clots in the blood vessels. Estrogen has also been found to increase production and activity of the artery protective nitric oxide and also functioning as an antioxidant. These promising studies resulted in recommendations that a regimen of low dose estrogen, with or without progesterone, could reduce the risk of cardiovascular disease in postmenopausal females.
"The problems with all the hormones is that they have other effects," said Rafael de Cabo, an investigator at the Laboratory of Experimental Gerontology, part of the U.S. National Institute on Aging. Two major studies found that HRT was actually increasing women's risk of heart attack by 29%, stroke by 41%, and the chances of breast cancer by 26%. In the August 1998 Journal of the American Medical Association, results of the Heart and Estrogen/Progestin Replacement Study (HERS) were published. In this randomized, placebo-controlled, clinical trial involving 2,763 postmenopausal women with established coronary disease, with an average age of 67, HRT appeared to increase the risk of CHD events during the first year of therapy. The second study (WHI) involved 16,608 postmenopausal women aged 50-79 years with no history of heart disease, and without a history of hysterectomy. This trial was stopped prematurely on May 31, 2002, due to a significantly increased incidence of breast cancer and CHD in the group on estrogen/progesterone. This data was reported in the July 17, 2002 issue of the Journal of the American Medical Association in an article entitled "Risks and Benefits of Estrogen Plus Progestin in Healthy Postmenopausal Women: Principal Results From the Women's Health Initiative Randomized Controlled Trial".
“When your estrogen levels drop it's your body's signal that you are no longer in childbearing years. Well, as you are losing your hormones, that also means your bones are going to get brittle.” Suzanne Somers. About 20 million American women currently use various forms of hormone replacement therapy. HRT is commonly used for relief of the symptoms of menopause, such as hot flashes, sweats and disturbed sleep. It is also used to prevent or decrease the rate of bone loss in osteoporosis. There is also some evidence that HRT may help prevent Alzheimer's disease, colon cancer, and the age related vision loss called macular degeneration. Side effects from taking HRT are usually short term and may include unusual vaginal discharge and bleeding, headaches, nausea, fluid retention and swollen breasts. And of course it can worsen cardiovascular disease. At this time, HRT should not be used for prevention of cardiovascular disease in postmenopausal women.
Male Hormone
“He's a guy. They don't talk, they fight. It's all that crazy testosterone.” British Actress Kim Cattrall. Testosterone is the principal male sex hormone and an anabolic steroid. It is produced by the testes, ovaries and the adrenals. Its main roles are enhancing libido, energy, and immune function, and protecting against osteoporosis. Testosterone levels in the males fall with advancing age, resulting in the male equivalent of the female menopause, called andropause. Elderly male population have the highest prevalence of coronary artery disease, and also relatively low testosterone levels. Men with high blood pressure have lower testosterone levels than normal men. In patients with chest pain, men with coronary artery blockages on the angiogram have lower testosterone levels than those with normal angiograms.
“I think that testosterone is a rare poison.” Germaine Greer. This may not be true. Testosterone therapy causes the coronary arteries to dilate and delays the onset of ischemia. There is also an anti-atherogenic effect. In addition, testosterone therapy improves the quality of life and depression scores in patients with coronary disease. This data was reported in Journal of the American College of Cardiology, May 17, 2005. There is some fear that testosterone may increase the risk of prostate cancer. At this time no definite recommendations can be made regarding testosterone supplementation for the prevention of heart disease.
“I have my hormones balanced. Most doctors are giving women synthetic hormones, which just eliminate the symptoms, but it's doing nothing to actually replace the hormones you have lost. Without our hormones we die.” Actress Suzanne Somers
Heart disease is the number one killer of both men and women in American and in most parts of the world. Female hormone replacement therapy (HRT) has been used in the recent past for reducing the risk of heart attacks and cutting down the risk of death in women with established heart disease. However, new data provides compelling evidence that HRT may actually make heart disease worse in women. On the other hand, since men suffer from earlier heart disease than women, it has been postulated that the male hormone, testosterone may increase the risk of heart disease. As a result, andropause, the male equivalent of menopause, has not been treated with male hormone replacement therapy, for heart disease prevention. Recent studies suggest that male hormone supplementation may be heart protective.
Female Hormones
Postmenopausal women have a higher risk of developing heart disease. Since menopause is associated with a decrease in the female hormones, it was postulated that HRT should help prevent heart disease. This logic was further supported by a study published in the August 28, 1997 issue of the New England Journal of Medicine, showing that estrogen increased the good HDL cholesterol comparably to the cholesterol lowering statin, simvastatin, and reduced both the bad LDL-cholesterol and Lp(a), another lipoprotein which increases cardiac risk. Research data also showed that in low doses, estrogen inhibited platelet aggregation and reduced PAI-1, plasminogen activator inhibitor, and thereby helped dissolve small blood clots in the blood vessels. Estrogen has also been found to increase production and activity of the artery protective nitric oxide and also functioning as an antioxidant. These promising studies resulted in recommendations that a regimen of low dose estrogen, with or without progesterone, could reduce the risk of cardiovascular disease in postmenopausal females.
"The problems with all the hormones is that they have other effects," said Rafael de Cabo, an investigator at the Laboratory of Experimental Gerontology, part of the U.S. National Institute on Aging. Two major studies found that HRT was actually increasing women's risk of heart attack by 29%, stroke by 41%, and the chances of breast cancer by 26%. In the August 1998 Journal of the American Medical Association, results of the Heart and Estrogen/Progestin Replacement Study (HERS) were published. In this randomized, placebo-controlled, clinical trial involving 2,763 postmenopausal women with established coronary disease, with an average age of 67, HRT appeared to increase the risk of CHD events during the first year of therapy. The second study (WHI) involved 16,608 postmenopausal women aged 50-79 years with no history of heart disease, and without a history of hysterectomy. This trial was stopped prematurely on May 31, 2002, due to a significantly increased incidence of breast cancer and CHD in the group on estrogen/progesterone. This data was reported in the July 17, 2002 issue of the Journal of the American Medical Association in an article entitled "Risks and Benefits of Estrogen Plus Progestin in Healthy Postmenopausal Women: Principal Results From the Women's Health Initiative Randomized Controlled Trial".
“When your estrogen levels drop it's your body's signal that you are no longer in childbearing years. Well, as you are losing your hormones, that also means your bones are going to get brittle.” Suzanne Somers. About 20 million American women currently use various forms of hormone replacement therapy. HRT is commonly used for relief of the symptoms of menopause, such as hot flashes, sweats and disturbed sleep. It is also used to prevent or decrease the rate of bone loss in osteoporosis. There is also some evidence that HRT may help prevent Alzheimer's disease, colon cancer, and the age related vision loss called macular degeneration. Side effects from taking HRT are usually short term and may include unusual vaginal discharge and bleeding, headaches, nausea, fluid retention and swollen breasts. And of course it can worsen cardiovascular disease. At this time, HRT should not be used for prevention of cardiovascular disease in postmenopausal women.
Male Hormone
“He's a guy. They don't talk, they fight. It's all that crazy testosterone.” British Actress Kim Cattrall. Testosterone is the principal male sex hormone and an anabolic steroid. It is produced by the testes, ovaries and the adrenals. Its main roles are enhancing libido, energy, and immune function, and protecting against osteoporosis. Testosterone levels in the males fall with advancing age, resulting in the male equivalent of the female menopause, called andropause. Elderly male population have the highest prevalence of coronary artery disease, and also relatively low testosterone levels. Men with high blood pressure have lower testosterone levels than normal men. In patients with chest pain, men with coronary artery blockages on the angiogram have lower testosterone levels than those with normal angiograms.
“I think that testosterone is a rare poison.” Germaine Greer. This may not be true. Testosterone therapy causes the coronary arteries to dilate and delays the onset of ischemia. There is also an anti-atherogenic effect. In addition, testosterone therapy improves the quality of life and depression scores in patients with coronary disease. This data was reported in Journal of the American College of Cardiology, May 17, 2005. There is some fear that testosterone may increase the risk of prostate cancer. At this time no definite recommendations can be made regarding testosterone supplementation for the prevention of heart disease.