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Hormone Supplementation for Heart Health – Good or Bad?
“My hormones are out of balance. Most doctors give women synthetic hormones that only relieve the symptoms, but it does nothing to actually replace the lost hormones. Without our hormones, we die.” Actress Suzanne Somers
Heart disease is the leading killer of both men and women in the United States and most of the world. Female hormone replacement therapy (HRT) has recently been used to reduce the risk of heart attack and death in women with diagnosed heart disease. However, the new data provide strong evidence that HRT can actually worsen heart disease in women. On the other hand, since men suffer from heart disease earlier than women, it is believed 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 to prevent heart disease. Recent research suggests that male hormone supplementation may protect the heart.
Postmenopausal women are at greater risk of developing heart disease. Because menopause is associated with a decline in female hormones, it was thought that HRT should help prevent heart disease. This logic was further supported by a study published in the August 28, 1997, New England Journal of Medicine, showing that estrogen increased levels of good HDL cholesterol compared to the cholesterol-lowering statin, simvastatin, and decreased both levels of bad LDL cholesterol, Lp( a), another lipoprotein that increases heart risk. Research data also showed that low-dose estrogen inhibited platelet aggregation and reduced PAI-1, a plasminogen activator inhibitor, and thus helped dissolve small blood clots in blood vessels. Estrogen has also been found to increase the production and activity of the artery-protecting nitric oxide, and to act as an antioxidant. These promising studies suggested that a low-dose estrogen regimen with or without progesterone could reduce the risk of cardiovascular disease in postmenopausal women.
“The problem with all hormones is that they have other effects,” said Rafael de Cabo, a researcher at the Laboratory of Experimental Gerontology, part of the US National Institute on Aging. Two major studies found that HRT actually increases women’s risk of heart attack by 29%, stroke by 41% and breast cancer by 26%. In August 1998, the results of the Heart and Estrogen/Progestin Replacement Study (HERS) were published in the Journal of the American Medical Association. In this randomized, placebo-controlled clinical trial of 2,763 postmenopausal women with diagnosed coronary artery disease with a mean age of 67 years, 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 to 79 years who had no history of heart disease and had not had a hysterectomy. This study was terminated early on May 31, 2002 because of a significant increase in the incidence of breast cancer and CHD in the estrogen/progesterone group. These data were reported in the July 17, 2002, issue of the Journal of the American Medical Association in an article titled “Risks and Benefits of Estrogen Plus Progestin in Healthy Postmenopausal Women: Main Results from the Women’s Health Initiative Randomized Controlled Trial.”
“When your estrogen levels drop, it’s your body’s signal that you’re no longer of reproductive age. Because you’re losing hormones, it also means your bones will become brittle.” Susan Somers. About 20 million American women currently use various forms of hormone replacement therapy. HRT is commonly used to relieve menopausal symptoms such as hot flashes, sweating, and trouble sleeping. It is also used to prevent or reduce bone loss in osteoporosis. There is also some evidence that HRT may help prevent Alzheimer’s disease, colon cancer, and an age-related vision loss called macular degeneration. Side effects of HRT use are usually short-lived and may include unusual vaginal discharge and bleeding, headache, nausea, fluid retention, and swollen breasts. And, of course, it can worsen cardiovascular disease. Currently, HRT should not be used to prevent cardiovascular disease in postmenopausal women.
“He’s a guy. They don’t talk, they fight. It’s all crazy testosterone.” British actress Kim Cattrall. Testosterone is the main male hormone and anabolic steroid. It is produced by the testicles, ovaries and adrenal glands. Its main roles include improving libido, energy and immune system, as well as protection against osteoporosis. Testosterone levels in men decline with age, resulting in the male equivalent of female menopause, called andropause. Older men have the highest prevalence of coronary artery disease and relatively low testosterone levels. Men with high blood pressure have lower testosterone levels than normal men. Male chest pain patients with coronary artery occlusion have lower testosterone levels on angiogram than those with normal angiograms.
“I think testosterone is a rare poison.” Germaine Greer. This may not be true. Testosterone therapy induces coronary artery dilation and delays ischemia. There is also an anti-atherogenic effect. In addition, testosterone therapy improves quality of life and depression scores in patients with coronary artery disease. These data were reported in the Journal of the American College of Cardiology, May 17, 2005. There is some concern that testosterone may increase the risk of prostate cancer. At this time, no specific recommendations can be made regarding testosterone supplementation for the prevention of heart disease.
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