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Menopause and HRT


In The News

Stress-related estrogen loss increases heart attack risk

Recent research suggests that reduced estrogen levels caused by stress can put some young women at an increased risk of getting heart disease. 

Heart disease is the No.1 killer of women, causing more than 250,000 deaths a year in the United States. Ninety percent of those deaths occur after menopause. 

Research done on female monkeys at Wake Forest University-Baptist Medical Center suggests stress can reduce estrogen levels much earlier in life and cause damage to arteries that can lead to heart attacks and strokes. 

"A deficiency of estrogen before menopause places these females on a high-risk path, regardless of whether they get estrogen treatment after menopause," said Jay Kaplan, a professor of comparative medicine at Wake Forest, speaking at the North American Menopause Society meeting in Orlando, Florida in September 2000. 

"Our data and recent studies in humans suggest that the emphasis in this country on postmenopausal estrogen treatment may be misplaced," Kaplan said. 

The monkeys, a species of macaques, were selected for the study because they resemble humans in behavioral and reproductive characteristics. They have a 28-day menstrual cycle and the females seem to have a natural resistance to heart disease, unless they are stressed. 

For the study, the female monkeys were placed in groups where they could naturally establish a social structure, from dominant to subordinate. The monkeys that were socially stressed because they were at the bottom of the pecking order produced reduced amounts of estrogen. 

Kaplan and his colleagues found that the estrogen-deficient monkeys had four times more arterial disease than dominant monkeys producing normal amounts of estrogen. 

When the stressed monkeys were given estrogen treatments either before menopause in the form of oral contraceptives or afterward, with hormone replacement therapy, their rates of artery blockage were cut in half. But if they got the treatment both before and after menopause, their rate of artery disease matched that of the dominant monkeys. 

Researchers at Ohio State University last year found a similar protective effect against high blood pressure from estrogen therapy on young female rats. 

" Applied to women, this life- time study suggests that having an estrogen deficiency in the pre- menopausal years predicts a higher rate of heart disease after menopause, even when treated with hormone replacement therapy," Kaplan said. 

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