I read two articles this weekend that reminded me of the importance of hormone therapy for overall health. These articles discussed the increased risk of developing heart disease and type 2 diabetes.
The first article compared the risk of developing type 2 diabetes based on the age of menopause. Basically, early menopause resulted in an increased risk of developing diabetes. The authors concluded: “Associations between age at menopause and risk of T2DM are usually attributed to the function of the reproductive system and changes in levels of hormones, including endogenous estrogen and androgen.” Risk factors for diabetes are related to changes in lipid metabolism, BMI, and fat mass in the menopausal woman.
Two large women’s health studies, the Women’s Health Initiative (WHI) and the Heart Estrogen and Progestin Replacement Study (HERS) concluded estrogen therapy could lower the risk of developing type 2 diabetes. It is also important to avoid surgical menopause (removal of the ovaries) when having a hysterectomy if possible.
The second article discussed heart disease. Numerous studies as well as the studies mentioned above have shown a positive correlation of reduction of cardiovascular disease and hormone replacement. This study looked at the risk of a cardiovascular event in women with premature ovarian failure (early menopause). The risk of heart disease increases with the loss of estrogen. Estrogen helps maintain the heart muscle, decrease the formation of plaque and the flexibility of blood vessels. Other studies also concluded that both natural menopause, surgical menopause, as well as premature ovarian failure results in increased risk of heart disease. Diabetes is also a very significant risk factor for developing heart disease.
The additive effects of hormone deficiency and the risks of diabetes and heart disease warrants an evaluation of the risks and benefits of hormone therapy beyond the concerns of breast cancer.
Raj Syal MD, FACOG