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Estrogen protects hearts until menopause
What estrogen does
While a woman is menstruating, estrogen keeps her cholesterol a little better, her inflammatory markers a little lower, and her blood pressure a little lower. After menopause the body no longer makes it. Weight goes up from rising inflammatory markers, blood pressure goes up, good cholesterol drops, and bad cholesterol rises. Pre-diabetes and blood sugar abnormalities become more likely.
Change before the last period
The change begins well before the last period. The average age of menopause, one year without a period, is about 50 or 51 in the United States, but things start shifting for a decade or more before that: poorer sleep, weight challenges, small blips in blood pressure. Perimenopausal women are twice as likely to have poor heart health.
The neglected decade
That decade tends to be the time women are least likely to seek care. They are raising a family, building a career, and watching their parents age. As few as 30 percent of women get their own checkup in the first year after having a baby, which sets in a habit of not taking care of themselves.
How does estrogen help blood vessels?
Estrogen prompts the cells lining blood vessels to produce nitric oxide, a molecule that relaxes the vessel wall and lets blood flow more freely. It also acts on the liver, where it tends to lower LDL cholesterol and raise HDL cholesterol. Estrogen has antioxidant and anti-inflammatory effects in laboratory studies as well. These effects work together on the arteries.
Why does blood pressure climb after menopause?
As estrogen falls, blood vessels lose some of the relaxing effect it provided. Arteries also stiffen with age, which raises the pressure needed to push blood through them. American Heart Association statistics show that before about age 55, men have higher rates of high blood pressure than women, and that by 65 and older the pattern reverses. Researchers think the loss of estrogen is part of the reason.
Why does body fat shift around menopause?
The Study of Women's Health Across the Nation, a long-running US study, followed midlife women through menopause and documented a gain in fat around the abdomen. Before menopause, fat tends to settle on the hips and thighs. Fat around the abdomen sits near the organs and releases inflammatory molecules that fat on the hips and thighs produces less of. That kind of fat is more strongly tied to insulin resistance and heart disease.
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