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Estrogen and HRT— Researchers Examine Potential for Cardiovascular Disease Treatment

Cardiovascular disease (CVD) kills more Americans each year than any other medical condition, a fact that places enormous pressure on the medical community to develop new treatment avenues.

Statistics from the Center for Disease Control are available here.

A smiling woman wearing a white blouse discusses her health condition with a doctor wearing a green shirt. They may be discussing the connection between estrogen and cardiovascular disease

These three scientifically observed trends, among others, have led researchers to study the role of estrogen in preventing heart disease and explore the use of estrogen and Hormonal Replacement Therapy (HRT) to reduce the risk of cardiac events:

  • Women of reproductive age, when estrogen production remains high, have lower rates of CVD compared to men of the same age
  • The prevalence of coronary artery disease (CAD) is greater among young women who had an oophorectomy (ovary removal) compared to women in the same age bracket with intact ovaries, further evidence of a protective effect of estrogen
  • The risk of heart disease among women increases at approximately the age of 50, coinciding with the onset of menopause and its associated sharp reduction in estrogen production

Estrogen and Heart Disease Prevention: Recent Research Shows Promise

While most evidence suggests that estrogen has the potential for increasing blood clotting events, a recent clinical trial assessing HRT on cardiovascular events in recently postmenopausal women over 10 years did not reveal an increased risk of blood clots and showed a significantly reduced risk of cardiovascular disease, without any apparent increase in risk of cancer or stroke.

A summary of recent research into estrogen’s potential role in prevention of cardiovascular disease shows estrogen having a potential protective effect on the cardiovascular system.

Researchers also believe that targeting specific estrogen receptors in the cardiovascular system may result in new and possibly safer therapeutic options that take advantage of estrogen’s potential to protect the heart.

Safety Concerns Remain Unanswered

Research trends related to estrogen’s action on the cardiovascular system provide hope for the utilization of hormones in future treatments.

However, further research is needed.

Preventative treatment to reduce heart disease risk would mean prolonged use of estrogen replacement therapy. Concerns about the safety of long-term HRT still remain unresolved.

The Women’s Health Initiative (WHI)

In a large, well-designed clinical trial, the Women’s Health Initiative examined the effectiveness of hormone replacement therapy in reducing the risk of heart disease in postmenopausal women over a 13-year period.

Although cardiovascular benefits were observed, overall health risks potentially associated with long-term estrogen replacement therapy were also detected, leading researchers to conclude:

“Hormone therapy affects many organ systems in the body and changes the risks of many diseases—some in good ways, others in bad ways. Depending on hysterectomy status, age, and other individual factors, the consequences can vary dramatically.”

Read this news release from the National Institutes of Health for more information on the study.

American Heart Association Conclusions

Similarly, the American Heart Association and the U.S. Food and Drug Administration offered the following conclusions based overall research trends:

  1. HRT should not be used for prevention of heart attack or stroke
  2. Use of HRT for other problems such as preventing osteoporosis should be carefully considered and the risks weighed against the benefits
  3. Women who have existing coronary artery disease are advised to consider other options
  4. Long-term use is discouraged because the risk for heart attack, stroke, and breast cancer may increase the longer HRT is used
  5. HRT may be used short-term to treat menopausal symptoms

Reaching similar conclusions, physicians at the Miller Family Heart & Vascular Institute at Cleveland Clinic, strongly suggest weighing the benefits of HRT against the risks through a comprehensive discussion of HRT with your physician in order to make the most informed decision possible.

Low Estrogen and Menopause: Learn More

In short, HRT is a valuable short-term treatment for the symptoms of menopause and hormone imbalance, but its further treatment applications are still in the research phase.

For more information about the symptoms and causes of low estrogen, menopause, hormone-associated weight gain, treatment options, and more, read our comprehensive guide to all things “low estrogen.”

Read the Guide

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(Augie) Juan Augustine Galindo Jr. MPAS, PA-C

(Augie) Juan Augustine Galindo Jr. MPAS, PA-C started his career in healthcare as a fireman/paramedic in West Texas where he served on the Midland Fire Department from 1998-2004.   He became interested in testosterone treatment after seeing how hormone replacement doctors helped those suffering from low testosterone.   After graduating from the Texas Tech Health Sciences Center Physician Assistant Program, he moved to DFW where he currently lives with his wife and three children.

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