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Protective Effects of Estrogen and Heart Health

Heart disease continues to be the leading cause of death for women in the United States and worldwide. It is reported that 1 in every 3 women dies from heart disease, one death every 80 seconds. In perimenopause and menopause there is an increased risk of cardiovascular disease (CVD) due to physiological effects of estrogen withdrawal, changes in body fat distribution, decreased glucose metabolism, abnormal lipids (cholesterol), higher blood pressure, and vascular inflammation (Davis, MD, FACC, 2020).  Furthermore, conditions not limited to and including PCOS, Premature or early menopause, perimenopause, autoimmune diseases, and menopausal women are high risk for CVD with physiologic low levels of estrogen.

The American College of Cardiology continues to update their position and statements specifically stating that hormone replacement therapy is associated with improved heart health and overall survival in women (American College of Cardiology, 2024). Moreover, estrogen replacement improves quality of life, reduces the risk of all cause heart disease and mortality by 52% than those NOT on hormone therapy (Mack & Hodis, 2023).

Estrogen is known to be cardio-protective, anti-inflammatory, therefore, untreated premature menopause, perimenopause, and menopause is associated with higher adverse risks of CHD, parkinsonism, cognitive decline, dementia, osteoporosis, and mortality.



American College of Cardiology. (2024, April 02). Heart Health Declines Rapidly After Menopause. Retrieved from American College of Cardiology:

Davis, MD, FACC, M. (2020, February 10). Hormone Therapy for Postmenopausal Women. Retrieved from American College of Cardiology:

Fact or Fiction? The Role of Regulated Body Identical Hormone Therapy for Postmenopausal Women. (2022, February 18). Nursing for Women's Health, 26(2), pp. 143-151. doi:

Mack, W., & Hodis, H. N. (2023, January 1). Menopausal Hormone Replacement Therapy and Reduction of All-Cause Mortality and Cardiovascular Disease: It’s About Time and Timing. Retrieved June 7, 2024, from Department of Health and Human Services:

The North American Menopause Society. (2022, May 2). The 2022 hormone therapy position statement of The North American Menopause Society. The Journal of The North American Menopause Society, 29(7), 767-794. doi:10.1097/GME.0000000000002028



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