Heart disease is the leading cause of deaths, not only in the United States, but also globally. Once thought to be a “man’s disease,” women are just as affected and have the same number of deaths as men each year from heart disease in the United States.
While staying at a healthy weight, eating a healthy diet, getting regular exercise, managing your stress and blood sugar, as well as controlling your blood pressure, cholesterol and triglyceride levels are all key to reducing your chances of getting heart disease, we may be missing an important part of the puzzle – the effect our hormones have on heart health and helping to accomplish the above list of positive health goals.
Estrogen and Heart Disease
Studies have shown women experience an increased risk of heart disease after menopause, increasing to one in four women dying of the disease a year. Researchers have connected this pattern to decreasing levels of estrogen during menopause.
In fact, low estrogen before menopause also puts women at risk. A study in the Journal of Clinical Endocrinology & Metabolism in 2016 noted premenopausal women with estradiol concentrations at or below the 10th percentile had a higher risk of stroke.1 That means it is important to have your hormones levels checked and at optimal range as you enter your mid-to-late 30’s.
Proper estrogen balance is associated with higher levels of high-density lipoprotein (HDL or “good cholesterol”) and lower levels of low-density lipoprotein (LDL or “bad cholesterol”). The decline of natural estrogen that occurs in menopause leads to lower HDL and higher LDL thus leading to the increased risk of heart disease and stroke.
Men need estrogen, too. Optimal range for men is 30-70 pg/ml, and a study from the Journal of the American Medical Association in 2009 found in 501 men with chronic heart failure, those with low testosterone and low estrogen had an 96% increase in overall mortality. In fact, men with the lowest estradiol levels were 217% more likely to die during a 3-year follow up.
Testosterone Decline and Increase in Disease
Men age 30-70 lose 1-3% of total testosterone production per year. Women ages 20-40 lose 50% of their testosterone production.
Low testosterone appears to be a predictive marker for those at high risk for cardiovascular disease.2 Not only does low testosterone in men and women increase their risk of heart disease and stroke, but testosterone deficiency is also associated with type-2 diabetes, metabolic syndrome, cancer, coronary artery disease, transient ischemic attacks, and dementia.1, 2
The Need to Optimize Your Hormones
As people live longer, more and more people are entering menopause and andropause. (Andropause typically occurs between the ages of 40 and 60, but men as young as 30 may begin to experience male menopause symptoms which are attributed to a gradual decline in testosterone levels.)
As hormones are depleted cholesterol goes up, blood pressure rises, and inflammation in blood vessels increases.
However, when we optimize the hormones that have been depleted in men and women, we see restored blood flow to the coronary arteries, decreased plaque formation, increased HDL, decreased LDL and triglycerides, and reduced inflammation in the blood vessels.
“For far too long, testosterone has been stigmatized by its undeserved association with the over-use and abuse anabolic steroids,” states Dr. Jerald Bain, an endocrinologist at the Univ. of Toronto Dept of Medicine and the Toronto Mount Sinai Hospital.
While there is a concern about synthetic oral hormones (which pass through the liver), hormones delivered by subcutaneous bioidentical hormone replacement therapy (BHRT) pellet implants bypass the liver, do not affect clotting factors, and do not increase the risk of thrombosis.3 Bioidentical hormone therapy is a compound that is identical to the natural molecules that the body produces. They are formulated from plant sources by pharmacists to match the body’s hormones identically.
Testosterone and estradiol delivered by pellet implantation do not adversely affect blood pressure, glucose or liver functions. Testosterone BHRT implants have been used in both men and women in five continents since the 1930’s. The longevity of this science-based modality attests to the fact that, when properly managed, bio-identical hormone replacement through the use of pellets is scientifically recognized as effective, safe, and the most effective method available for administering hormone replacement therapy.3,4,5,6
When optimized, natural estrogen, natural testosterone, and natural progesterone protect the heart, brain and other body systems. When in balance, the natural bio-identical hormones work as antioxidants, reduce inflammation in the blood vessels, improve blood flow to the coronary and other arteries in your body, and decrease plaque format.7
There are numerous studies showing that testosterone protects the heart. For example, researchers from the University of Texas at Galveston performed a large study using testosterone in elderly men. Their results, published in the Annals of Pharmacotherapy in July 2014, showed 50% fewer deaths and a reduction in heart attacks in men using testosterone.
Testosterone and estradiol improve lipid profiles by reducing total cholesterol, triglycerides, and LDL levels while increasing HDL cholesterol as well as decreasing blood pressure.8 This all has positive benefits on the cardiovascular system and helps to meet the goals of maintaining cardiovascular health.
Long term, men and women will not only have a reduced incidence of heart disease when they optimize their hormones through BHRT pellet therapy, but also Alzheimer’s disease and osteoporosis.9
For those concerned about the risk of breast cancer with hormone therapy, there are multiple studies showing the long term reduction in breast cancer in women using bio-identical hormone replacement therapy through the use of pellets rather than the increase in the incidence of breast cancer that has been associated with oral, synthetic hormones. 3, 10, 11 Even after twenty years of therapy with hormone implants, the risk of breast cancer is not increased.12
Given this information, the conclusion is that hormone balance and optimization play a larger role in cardiovascular and overall health than many people are aware of. Consider having your hormones levels checked to see if they are in optimal range and if you could benefit from having BHRT pellet therapy to optimize your hormones and health.
Karla Vavra Melcher, RN, BSN is a nurse and certified BioTE provider at Restore Health & Wellness Center
1. Journal of Clinical Endocrinology & Metabolism, Jan 2016
4. Salmon, U., et al. Use of estradiol subcutaneous pellets in humans. Science 1939, 90: 162.
6. Journal of Advanced Nursing, 47(5), 467–474
7. Dr.Gary Donovitz, Age Healthier, Live Happier, 2014
9. doi: 10.1016/j.maturitas.2013.08.002. Epub 2013 Sep 10. Reduced breast cancer incidence in women treated with subcutaneous testosterone, or testosterone with anastrozole: a prospective, observational study. Glaser RL1, Dimitrakakis C.
12 Gambrell 06, https://www.ajog.org/article/S0002-9378(99)70550-8/abstract
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