When oestrogen levels begin to fall around the peri and post menopause, the risk of heart disease and stroke begins to increase.
There are many factors why this may occur but the most likely ones are as follows:
Studies have shown that patients who are commenced on adequate oestrogen prior to the whole formation of plaque and arterial stiffening, their risk of cardiovascular disease, cerebrovascular disease and dementia is reduced in the long term.
Some studies have tried to reverse pre-existing damage and plaque formation by the addition of oestrogen because oestrogen - particularly oral oestrogen, has a dissolving effect on plaque. This can increase the risk of thrombosis or clot whereas taking oestrogen well in advance of arterial hardening and plaque formation is more beneficial for long term protection.
However, this does not mean oestrogen cannot be commenced many years after the menopause or in the existence of pre-existing plaque or arterial damage but caution must be applied and may wish to discuss this with your cardiologist and possibly take blood thinning medication alongside oestrogen for the high-risk time ie. the first 6-8 weeks. Following that, once the initial risk has reduced then long term benefit may well be achieved by preventing any further plaque formation.
In women, bone is very sensitive to oestrogen. Usually it is in a state of constant placement of old bone with new and oestrogen maintains this process preserving the strength of the bone. Loss of oestrogen results in increased breakdown of bone but inadequate replacement of new bone and a reduction of bone density can occur. If this is left too long, then even replacing oestrogen or using other medications to try and improve bone density will not work as there are already micro factors within the honeycomb of the bone.
The highest risk areas are:
In patients who are at high risk of osteoporosis such as early menopause, sedentary lifestyle, previous use of steroids, family history of osteoporosis, it is worth considering a baseline bone density scan at the beginning of the menopause to ensure that deterioration does not occur before it is reversable.
Collagen in the female body is very sensitive to oestrogen and as oestrogen levels begin to decline, the collagen matrix begins to thin and becomes less elastic. This can present in many different ways and supplementing adequate oestrogen replacement can completely or partially reverse this change. This is why women who experience an early menopause or who are under replaced such as after a hysterectomy or with down regulation of the ovaries early (Mirena, contraceptive pill), without adequate addback oestrogen can exhibit signs of premature ageing. The concern is that if collagen ages externally this can indicate premature ageing internally (bone, artery wall, ligaments etc.) Collagen affects:
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