We spoke with Dr. África Rebollo, a specialist in Gynecology with more than twenty years of experience, to explain the relationship between menopause and cardiovascular health in women.
Does the hormonal change that occurs during menopause affect cardiovascular health?
Before menopause, the risk of cardiovascular disease is much lower in women than in men. Menopause does not produce cardiovascular disease, but the decrease in estrogen seems to be involved in the increased risk.
Is there a relationship between the hormonal changes of menopause and the increase in ‘bad’ cholesterol?
After menopause there is usually an increase in cholesterol at the expense of LDL cholesterol or “bad cholesterol”, decreasing HDL cholesterol or “good cholesterol”. Increased LDL cholesterol can produce plaques inside the blood vessels, contributing to the development of cardiovascular disease. This lipid alteration is also attributed to the decrease in estrogen.
Menopause does not lead to cardiovascular disease, but the decrease in estrogen appears to be involved in the increased risk of cardiovascular disease.
What treatments are available to treat menopause?
There are situations in which, for various reasons, the patient does not require TSH (hormone replacement therapy). Patients who have menopause suffer from a series of symptoms, the most frequent being hot flushes, vaginal dryness and insomnia.
There are solutions to alleviate these symptoms:
For hot flashes: there are various treatments, from isoflavones, to pollen husks and centrally acting drugs.
For vaginal dryness: often accompanied by dyspareunia, there is also a wide range of drugs, from moisturizing creams to those containing hormones that usually produce greater relief. In recent years, prasterone and ospemifene have been added to this therapeutic arsenal with very encouraging results.
What is hormone replacement therapy (HRT)?
There are multiple treatments for menopause, such as HRT, a therapy that basically consists of providing estrogens or molecules with estrogenic action and gestagens to reduce the risk of endometrial pathology.
The presentation of these drugs varies widely, from oral tablets, vaginal, gel, spray, patches, subdermal implants.
The latter, which are relatively new, are based on bioidentical hormones, i.e. estrogens and gestagens identical to those normally circulating in women.
Mention should be made of tibolone, a compound with estrogenic, gestagenic and androgenic action, which is administered orally.
Recommendations for women who are beginning to experience menopause
Menopause does not happen suddenly, in general, the periods are spaced out, missing some months and sometimes during this time the woman may experience some of the symptoms mentioned above. It is a new stage of life, just as adolescence was, of course, but it catches us older and is less exciting.
I do not believe in special advice, continue a healthy life, exercise to fight against osteopenia, go to the gynecologist and more if there are symptoms that reduce the quality of life in order to alleviate them. And above all, be happy.